Claims Assistant

Position Overview:

What's in it for You:

• Medical, Dental, Vision Benefits
• Competitive Compensation
• 401K eligible upon 1st day of employment
• FSA & DCA Accounts
• Career advancement opportunities in an expanding company

As Claims Assistant, you will coordinate between insureds, brokers, nurse case managers, defense counsel, and external vendors to ensure efficient and pro-active claims handling.

Essential Job Functions:

• Responsible for completing and documenting initial loss investigations on low and midlevel workers compensation claims to determine compensability under close

• Under direction and guidance of the claim supervisor, 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 relationship to reported claim.
• Liaison with insureds, nurse case managers, and counsel to oversee management of claims and bring them to closure and facilitate full or transitional duty return to work.
• Responsible for EDI and other claims coding functions along with data entry and report generation.
• Respond to inquiries and request for information from insureds, brokers, medical providers and other external parties.
• Under close supervision, prepare and present claim review summaries for insureds, brokers, internal contacts as requested.
• Participate in roundtable discussions internal colleagues, insureds, and counsel on strategies for successful claim closure/resolutions.
• Support other members of the claims department with larger or more complex claims as assigned.
• Under supervision of claims supervisor assist the insured onboarding process including training on claims reporting and the use of the insured portal.
• Performs other duties as assigned.

Required Skills/Abilities/Experience:

• High School Diploma or equivalent (Associate's or Bachelor's degree preferred).
• Minimum of three (3) years of experience in worker's compensation, claims management, or administrative role is preferred.
• Previous experience in workers' compensation claims management, specifically medical-only claims, is preferred.
• Proficient in Microsoft Office and has an aptitude to learn other software applications.
• Excellent oral and written communication skills.
• Detail oriented with a high accuracy rate.
• Ability to problem solve and use good judgment.
• Self-motivated with excellent time management skills.
• Onsite presence at our office in Spring Valley, NY required.

This list of functions, duties, responsibilities, and skills is not intended to be all-inclusive, and the employer reserves the right to assign additional duties and responsibilities as necessary.

All employment is decided based on qualifications, merit, and business need.

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Pay Range: USD $25.00 - USD $30.00 /Hr.