- Communicates via mail, phone, and email with injured workers, employers, and medical providers.
- Sets up file diaries, documents follow-up care, and other claim-related activities.
- Assesses reserves appropriately and timely with authority level not to exceed $2,500.
- Reviews and responds to incoming mail, emails, telephone calls, and fax transmissions from providers and injured workers and takes actions required.
- Moves inventory to closure or upgrades as injuries evolve.
- Responsible for bringing files to supervisor's attention when issues become complex.
- Supports the process by scheduling medical or testing appointments to determine appropriateness of medical care being received related to injury.
- Authorizes/certifies medical treatment in line with Utilization Review Regulations and as outlined within department UR plan.
- Identifies, investigates, and pursues subrogation cases.
- Follows up with medical providers to obtain results.
- Maintains effective communications with other departments and maintains a good working relationship with customers.
- Reviews and approves or denies medical bills and returns bills with insufficient information.
- Processes bills in the bill paying and tracking system or issue for processing by others.
- Ensures timely payment of bills to assure treatment continuity.
- High school diploma or general education degree (GED) required.
- Minimum 1 year of related experience and/or training; or equivalent combination of education and experience.
- Texas Workers' Compensation License is a plus.
- Ability to read, write and comprehend simple instructions, short correspondence, and memos.
- Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.
- Ability to read, analyze, and interpret technical journals, financial reports, or legal documents.
- Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community.
- Ability to add, subtract, multiply, and divide using whole numbers, common fractions, and decimals.
- Ability to define problems, collect data, establish facts, and draw valid conclusions.
- Challenging work and the ability to make a difference
- You will have a voice and feel a sense of belonging
- We offer a competitive benefits package, with generous medical, dental, and vision plans as well as 401K retirement plans and company match
- Bonus potential for all positions
- Paid Time Off with an accrual rate of 5.23 hours per pay period (equal to 17 days per year)
- 10 paid holidays throughout the calendar year
- Want to continue learning? We'll support you 100%
-
Disability Claims Examiner
2 weeks ago
Illinois Municipal Retirement Fund (IMRF) Oak Brook, United States**INTRODUCTION** · The Illinois Municipal Retirement Fund (IMRF) provides death, disability, and pension retirement benefits to employees of local governments and school districts in Illinois (with the exception of the City of Chicago and Cook County). As is the second largest—an ...
-
Claims Examiner Employment Practices
1 week ago
USLI Oak Brook, United StatesThe ideal claims team member will be an analytical and creative problem solver with the ability to hone in on key issues for coverage, liability and damage evaluation. Our claim examiners are assertive decision makers with a strong desire to persuade through negotiation and confl ...
-
Medical Only Claims Examiner I
1 week ago
ICW Group Insurance Companies Lisle, United StatesAre you looking for more than just a job? Do you want to have a voice and feel a sense of belonging? At ICW Group, we hire innovative people who consistently adapt, grow and deliver. We believe in hard work, a fun work environment, and embracing crea Medical, Claims, Examiner, In ...
-
Claims Examiner
14 hours ago
Marsh McLennan Schaumburg, United States RegularEstablished as one of the premier insurance agencies in the USA, Marsh & McLennan Agency (MMA) is meeting the needs of mid-sized businesses across the country. MMA's services are targeted to customers who seek professional advice and have complex needs, limited resources and desi ...
-
Senior Claims Examiner
21 hours ago
Crawford & Company Lake Zurich, United StatesExcellence In Everything We Touch · Position Summary · Investigate and settle advanced, large loss, complex claims promptly and equitably under minimal supervision. Works within established authority on moderate-to-difficult claims. Reviews coverages, determines liability and c ...
-
Claim Examiner-Professional Liability
1 week ago
RLI Chicago, United StatesAbout Us · We're not like other insurance companies. From our specialty products to our business model, our culture to our results - we're different. Different is who we are, and how we work, interact, deliver and succeed together. Creating a different and better insurance expe ...
-
Senior Workers Compensation Claims Examiner
1 week ago
American International Group Chicago, United StatesAt AIG, we are reimagining the way we help customers to manage risk. Join us as a Senior Workers Compensation Claims Examiner to play your part in that transformation. It's an opportunity to grow your skills and experience as a valued member of the team. · Join us as a Senior WC ...
-
Senior Claims Examiner, Healthcare and Casualty
2 weeks ago
Berkshire Hathaway Specialty Insurance Chicago, United StatesJob Description · Job DescriptionWho are we? · A strategic and trusted insurance partner, Berkshire Hathaway Specialty Insurance (BHSI), provides a broad range of commercial property, casualty and specialty insurance coverages and outstanding service to customers and brokers arou ...
-
KING'S INSURANCE STAFFING LLC Chicago, United StatesOur client, an A-rated Insurance Carrier, is seeking to add a Senior Commercial General Liability Claims Specialist. This person would be responsible for directly handling moderate to complex litigated and non-litigated Commercial General Liability claims including Slip and Falls ...
-
Workers' Compensation Claims Supervisor
3 days ago
CorVel Corporation Downers Grove, United StatesThe Claims Supervisor is responsible for supervising a team of direct reports, ensuring all quality, productivity and customer service criteria are met while adhering to company policies and procedures. The Claims Supervisor position is integral to the success of the company and ...
-
Siu Associate
6 days ago
Sedgwick Naperville, United StatesTaking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportuni ...
-
Benefits Department Analyst
3 weeks ago
Illinois Municipal Retirement Fund (IMRF) Oak Brook, United States**INTRODUCTION** · The Illinois Municipal Retirement Fund (IMRF) provides death, disability, and pension retirement benefits to employees of local governments and school districts in Illinois (with the exception of the City of Chicago and Cook County). We are the second largest—a ...
-
Patient Financial Representative
2 weeks ago
The University of Chicago Medicine Ingalls Memorial Burr Ridge, United States**Job Description**: · Join a world-class academic healthcare system, **Ingalls Memorial Hospital**, as a **Patient Financial Services Representative - Finance **in the Patient Accounts department. · **LOCAL REMOTE OPPORTUNITY** · **Job Summary** · The Patient Financial Services ...
-
Avp, Claim Manager
1 week ago
Chubb Chicago, United StatesEnsure the delivery of timely and effective claims service through supervision of a team of examiners and technical assistants at various experience levels · - Train, mentor and develop staff who are at different stages of their career and experience levels · - Provide advanced t ...
-
Medical Biller/insurance
3 weeks ago
Good Hope Homehealth Chicago, United States**Responsibilities** · - Prepares and submits billing data and medical claims to insurance companies · - Ensures the clients medical information is accurate and up to date · - Prepares bills and invoices, and document amounts due to medical procedures and services · - Collects an ...
-
Tax Specialist
1 week ago
US Internal Revenue Service Chicago, United States**Duties**: · **WHAT IS THE **TAX EXEMPT/GOVERNMENT ENTITIES (TE/GE) DIVISION?** · Vacancies will be filled in the following specialty areas: · Tax Exempt and Government Entities, Exempt Organizations and Government Entities, Examinations, Compliance and Review · The following ar ...
-
Medical Assistant
3 weeks ago
Clay Consulting Chicago, United States**Medical Assistant (MA)** · Do you have a passion for contributing to the well-being of those who have bravely served our nation? If so, we invite you to join our esteemed team of professionals at Clay Consulting, a VA subcontractor. We are currently seeking a dedicated Medical ...
-
General Warehouse Associate I
3 days ago
TheRoomPlace Romeoville, United StatesTitle: General Warehouse Associate I Date: March 2017 · Dept: DC Operations Level: · Reports to: Warehouse Supervisor Exempt · Non · - Exempt · - _____________________________________________ · **Position Purpose**:Responsible for the loading and unloading incoming trucks in an e ...
-
Biller
3 weeks ago
GRO Community Chicago, United States**About GRO Community**: · God Restoring Order (GRO) Community is a mental healthcare provider that specializes in trauma recovery services for males of color ages 5 and up. GRO services are grounded in an understanding of the neurological, biological, and psychological effects o ...
-
Director, Patient Financial Services
3 weeks ago
Shirley Ryan AbilityLab Chicago, United StatesBy joining our team, you'll be part of our life-changing Mission and Vision. You'll work in a truly inclusive environment where diversity and equity are championed through words and actions. You'll contribute to an innovative culture that is second to none, one that embraces curi ...
Medical Only Claims Examiner I - Lisle, United States - ICW Group
Description
Are you looking for more than just a job? Do you want to have a voice and feel a sense of belonging? At ICW Group, we hire innovative people who consistently adapt, grow and deliver. We believe in hard work, a fun work environment, and embracing creativity that only comes about when talented people collaborate to develop solutions. Our mission is to create the best insurance experience possible.
Headquartered in San Diego with regional offices located throughout the United States, ICW Group has been named for seven consecutive years as a Top 50 performing P&C company offering the stability of a large, profitable and growing company combined with a small-company entrepreneurial spirit. Our purpose-driven ethos provides team members with opportunities to contribute, develop, and belong.
The Medical Only Examiner I will administer benefits in accordance with statutory and case law as well as pertinent regulations for an inventory comprised of minor injuries with no lost time. This position exists to reserve, manage, and bring Workers' Compensation claims to an equitable conclusion within the company standards and best practices guidelines.
Candidates will be required to work a hybrid schedule out of our Lisle, IL, Wayne, PA, or Lake Mary, FL offices.
WHAT YOU WILL DO
Receives and reviews information related to Medical Only claims.
The current hourly range for this position is $ to $ This range is exclusive of fringe benefits and potential bonuses.If hired at ICW Group, your final base salary compensation will be determined by factors unique to each candidate; including experience, education, and location of the role and considers employees performing substantially similar work.
WHY JOIN ICW GROUP?
#LI-TP1 #LI-Hybrid
