Job TitlePay Range: $32.85hr - $37.85hrRequirement/Must HaveWorking knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social Security and Medicare application procedure as applicable to line of business.PC literate, including Microsoft Office products.Analytical and interpretive skills.Strong organizational skill.Excellent negotiation skills.Ability to work in a team environment.Ability to meet or exceed Service Expectations.ResponsibilitiesManages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.Develops and manages workers compensation claims’ action plans to resolution, coordinates return-to-work efforts, and approves claim payments.Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.Manages subrogation of claims and negotiates settlements.Communicates claim action with claimant and client.Ensures claim files are properly documented and claims coding is correct.May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.Maintains professional client relationships.Performs other duties as assigned.Supports the organization’s quality program(s).SkillsWorkers Compensation Claims Adjudication.Subrogation Negotiation.Settlement Negotiation.Microsoft Office.Strong verbal and written communication skills.Excellent communication and presentation skills.Good interpersonal skills.Qualification And EducationBachelor’s degree from an accredited college or university preferred.
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