What are the responsibilities and job description for the Claims Assistant position at Laborintos?
Contamos con un equipo sólido y robusto de consultores especializados en búsqueda y selección de personal, así como en consultoría en diversos temas asociado al Talento Humano en múltiples sectores y países, garantizando de esta manera la prestación de un servicio oportuno y resolutivo a cada una de las empresas que nos confían la selección y / o el entrenamiento de sus profesionales.
Actualmente sumamos más de 10 años de experiencia en el manejo de procesos, tanto individuales como masivos, a nivel local y regional.
Top regional insurance company is seeking a workers compensation claims assistant for its office in Spring Valley, NY.
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 :
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