What are the responsibilities and job description for the Workers Compensation Claims Assistant I position at Intercare Holdings Insurance Services?
Summary:
Reports directly to the unit Claims Supervisor but takes primary direction for the assigned Claims Specialist(s). Responsible for providing clerical operations support to assigned Claims Specialist(s).
Essential Duties and Responsibilities:
- Prepares new claims files
- Calculates TTD, Wage Loss, VRMA and PD benefits
- Issues compensation payments on diary schedule
- Issues Benefit Notices
- Doctor status calls and Employee/Employer contact calls
- Employer contact calls to confirm light duty/modifies work
- Works closely with Claims Specialist to complete clerical assignments
- Prepares litigation documents such as C&R, Stipulations, Answers, etc
- Prepares rehabilitation forms for filing with the rehabilitation unit
- Handle calls from providers inquiring about unpaid bills and bill related questions
- Review Mail and process direct pays bills such as Mileage Reimbursement
- File and Serve duties (as needed)
- Notepad documentation in Portal
Competency:
To perform the job successfully, an individual should demonstrate the following competencies:
- Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations.
- Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
- Team Work - Supports everyone's efforts to succeed.
Qualification Requirements:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and/or Experience:
High school diploma or general education degree (GED); or 1-2 years related experience and/or training; or equivalent combination of education and experience.
