What are the responsibilities and job description for the Claims Assistant position at ExpertHiring?
Job Description
Top Reasons to Work with our client
Great work-life balance!
Market leader in commercial insurance and risk management!
Offer a wide range of career paths and opportunities for growth!
Competitive Compensation and Benefits : health insurance, retirement plans, and other benefits!
Job Type : Full Time Location : Spring Valley, New York Pay : Competitive Pay & Benefits! Job Description What you will be doing :
Conduct initial loss investigations on low and mid-level workers' compensation claims to determine compensability under close supervision.
Establish initial and subsequent reserves to ensure reserves are adequate for anticipated exposure with increasing degrees of responsibility and complexity.
Review and approve medical bills for causal relationships to reported claims.
Liaise with insureds, nurse case managers, and counsel to oversee the management of claims and facilitate full or transitional duty return to work.
Manage EDI and other claims coding functions along with data entry and report generation.
Respond to inquiries and requests for information from insureds, brokers, medical providers, and other external parties.
Prepare and present claim review summaries for insureds, brokers, and internal contacts as requested.
Participate in roundtable discussions with internal colleagues, insureds, and counsel on strategies for successful claim closures / resolutions.
Support other members of the claims department with larger or more complex claims as assigned.
Assist in the insured onboarding process including training on claims reporting and the use of the insured portal.
Experience you will need :
Proficient in Microsoft Office with an aptitude to learn other software applications.
Excellent oral and written communication skills.
Detail-oriented with a high accuracy rate.
Self-motivated with excellent time management skills.
Innovative thinker, passionate, go-getter.
Ability to manage multiple tasks and prioritize effectively.
High School Diploma or equivalent (Associate's or Bachelor's degree preferred).
At least 2-3 years prior experience in workers' compensation, claims management, or an administrative role is a plus.
Our client asked me to submit 3 great people within the next few days. We work directly with the hiring manager and can arrange interviews within a few days
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