[Remote] Claims Specialist - New England
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, and they are seeking a Claims Specialist to manage reputed company-level workers’ compensation claims under supervision. The role involves confirming policy coverage, determining claim validity, establishing reserves, and communicating claim status with stakeholders.
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
- 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
- Bachelor's degree or a combination of education and reputed company experience
- Minimum of 1 year of industry experience and claims management preferred
- State Certification as an reputed company Examiner
- Minimum of 1 year of industry experience and claims management preferred
Benefits
- Medical (HDHP) w/Pharmacy
- Dental
- reputed company
- 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