Job Description:
• Analyze Virginia Medical Only claims on behalf of our valued clients to determine benefits due.
• Ensure ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
• Process low level workers compensation claims determining compensability and benefits due on long term indemnity claims.
• Develop and coordinate low level workers compensation claims' action plans to resolution, return-to-work efforts, and approve claim payments.
• Approve and process assigned claims, determine benefits due, and administer action plan pursuant to the claim or client contract.
• Administer subrogation of claims and negotiate settlements.
• Communicate claim action with claimant and client.
• Ensure claim files are properly documented and claims coding is correct.
• Maintain professional client relationships.
Requirements:
• 2 years of claims management experience or equivalent combination of education and experience required.
• High School Diploma or GED required.
• Bachelor's degree from an accredited college or university preferred.
• Professional certification as applicable to line of business preferred.
• Jurisdiction Knowledge: VA
Benefits:
• Flexible work schedule.
• Referral incentive program.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
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