What are the responsibilities and job description for the Workers Compensation Claim Adjuster – Remote position at Fairview Health Services?
Lost Time and Medical Only Claim Adjuster for Work Comp Claims. Investigation and determination of liability for Fairview employee lost time and medical only workers’ compensation claims, to promptly pay benefits due to the injured worker, and to timely resolve claims in an effort to minimize loss of human and financial resources due to work-related injuries. Calculate and pay indemnity payments owed. Review of bills to determine if they are related and payable under the worker’s compensation claim. This position works closely with the Employee Occupational Health department.
This is a remote position!
Responsibilities Job Description
- Responsible for completion of claim investigation (interview manager/supervisor, injured employee, witnesses, and collection of medical reports related to the injury).
- Determine compensability of a work comp claim by applying the law to facts.
- Responsible for calculation and timely payment of all benefits: wage loss benefits, medical benefits, and any other expenses related to an employee injury.
- Maintain claim records with file documentation and attachments (wage information, benefits paid, medical records, bills, correspondence, rehabilitation reports, etc.) that substantiate claim file decisions.
- Responsible for timely payment of internal and external medical bills
- Assist in coordination of return to work activities.
- Communication with Employee Occupational Health Services, medical provider, injured employee, and manager to ensure all parties have appropriate information and share the same goals in managing the injured employee.
- Complete State required EDI reporting.
- CMS Reporting of eligible claims – reporting IDC10 Codes, Award/Settlement Payments
Qualifications
Workers' Compensation Claims Management experience with medical only claims and some lost time claims management experience is helpful but willing to train if candidate has work comp medical only claims experience.
Minimum Education:
High School Diploma/G.E.D.
Preferred Education:
Bachelor’s Degree in Business or related area.
Minimum Experience:
2 years of experience in handling workers’ compensation claims.
Preferred Experience:
2 years of experience in handling lost time worker’s compensation claims.
EEO Statement
EEO/AA Employer/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status
