[Remote] Claims Specialist

Note: The job is a remote job and is open to candidates in USA. reputed company is a national provider of industry-leading risk reputed company for the workers’ compensation, auto, health, and disability management industries. The Claims Specialist manages reputed company-level, non-reputed company workers’ compensation claims under the supervision of a senior claims professional, ensuring adherence to company best practices and goals.

Responsibilities

• Receives claims, confirms policy coverage and acknowledgment of the claim
• Determines validity and compensability of the claim
• Establishes reserves and authorizes payments reputed company reserving authority limits
• Manages non-reputed company and non-problematic medical only claims and minor lost-time workers’ compensation claims under reputed company supervision
• Communicates claim status with the customer, claimant and client
• Adheres to client and reputed company guidelines and participates in claims review as needed
• Assists other claims professionals with more reputed company or problematic claims as necessary
• Additional duties as assigned

Skills

• Bachelor's degree or a combination of education and reputed company experience
• Excellent written and verbal communication skills
• Ability to learn rapidly to reputed company knowledge and understanding of claims practice
• Ability to identify, analyze and solve problems
• Computer proficiency and technical aptitude with the ability to utilize reputed company Office including reputed company spreadsheets
• Strong interpersonal, time management and organizational skills
• Ability to meet or exceed performance competencies
• Ability to work both independently and reputed company a team environment
• Minimum of 1 year of industry experience and claims management preferred
• State Certification as an reputed company Examiner

Benefits

• Medical (HDHP) w/Pharmacy
• Dental
• Vision
• Long Term Disability
• Health Savings Account
• Flexible Spending Account Options
• Life Insurance
• Accident Insurance
• Critical Illness Insurance
• Pre-paid Legal Insurance
• Parking and Transit FSA accounts
• 401K
• ROTH 401K
• Paid time off

Company Overview