What are the responsibilities and job description for the Medical Claims Adjustor position at Volt?
Apply for tomorrow's opportunity today, with Volt!
Volt is immediately hiring for Medical Claims Adjustor in Piscataway, New Jersey.
Remote Must reside in New Jersey, Delaware or Pennsylvania
As a Claims Adjustor you will :
- Evaluate claimant eligibility; communicate with attending physician, employer and injured worker.
- Work with the claimant and their physician to medically manage the claim, from initial medical treatment to reviewing and evaluating ongoing medical treatment and related information.
- Work directly with employers to facilitate return to work, either on a full-time or modified duty basis.
- Confirm coverage and applicable insurance policy or coverage document and statutory requirements.
- Identify potential for third party recovery, including subrogation, Second Injury Fund or other fund involvement (when applicable) and excess or reinsurance reimbursement. Pursue the process of reimbursement and complete posting of recovery to the claim file, where appropriate.
- Identify potential for disability or pension credits or offsets.
- Assign field adjuster investigation on potentially suspect claims.
- Ensure timely denial or payment of benefits in accordance with jurisdictional requirements.
- Establish claim reserve levels by estimating the potential exposure of each assigned claim, establish appropriate reserves with documented rationale, maintain and adjust reserves over the life of the claim to reflect changes in exposure.
- Establish compensability status through case investigation and evaluation and application of jurisdictional statutes and laws.
- Where litigation is filed, evaluate exposure and work closely with defense counsel to establish strong defenses, prepare litigation plan of action, set legal reserve and manage litigation over life of claim.
- Manage diary in accordance with Best Practices and complete tasks to ensure that cases move to the best financial outcome and timely resolution.
- Close all files as appropriate in a timely and complete manner.
- Maintain closing ratio as directed by management team.
- Oversee and coordinate medical treatment for injured employees and provide information to treating physicians regarding employees' medical history, health issues, and job requirements; provide direction to assigned nurse case manager where applicable.
- Complete PARs (payment authorization request) when applicable
This is a full-time opportunity.
Pay Rate : $21.00 per hour
Qualified candidates should APPLY NOW for immediate consideration! Please hit APPLY to provide the required information, and we will be back in touch as soon as possible.
Benefits : Volt offers benefits (based on eligibility) that include the following : health, dental, vision, term life, short term disability, AD&D, 401(k), Sick time, and other types of paid leaves (as required by law), Employee Assistance Program (EAP).
Volt is an Equal Opportunity Employer and prohibits any kind of unlawful discrimination and harassment. Volt is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment on the basis of race, color, religion or belief, national origin, citizenship, social or ethnic origin, sex, age, physical or mental disability, veteran status, marital status, domestic partner status, sexual orientation, or any other status protected by the statutes, rules, and regulations in the locations where it operates. If you are an individual with a disability and need a reasonable accommodation to assist with your job search or application for employment, please contact us at
hr_dept@volt.com
Volt does not discriminate against applicants based on citizenship status, immigration status, or national origin, in accordance with 8 U.S.C. § 1324b.
Salary : $21
