Workers Comp Coord - Le Mars, United States - Wells Enterprise

Description

• Gathers claim information and submits claim to the Third-Party Administrator (TPA) in a timely manner.
• Provides supplementary claim information (wages, return to work status, medical provider info., incident investigation info., etc) to the TPA.
• Manages communication between parties involved in the claim to include medical providers, operations personnel, the TPA, the injured employee, Wells attorneys, etc.
• Attend quarterly file review meetings and other claim meetings as required.
• Manages discovery request for litigated claims.
• Run claim reports and conduct analysis for both internal and external parties as necessary.
• Manages the pharmacy program.
• Manages employee mileage reimbursement and the appointment calendar.

• Minimum of a two-year Associates Degree
• Two years of claims handling experience, insurance experience, or other related job experience.
• Knowledge - Basic claims or insurance knowledge is preferred. Familiarity with State Workers Compensation regulations along with Health Insurance Portability and Accountability Act (HIPAA) Regulations.
• Strong communication skills required, both written and verbal.
• Effective interpersonal skills in working with internal and external customers as well as high level of organization, accuracy and detail.
• Proficient computer skills.
• Ability to operate at a high level of confidentiality and discretion as well as ability to work under pressure and effectively prioritize work.
• Reports to Director Corporate Risk Management
• Direct Reports - None
• Indirect Reports - None
• Approximate annual claims budget of $750,000