Claims Representative

Direct Hire 70-75k
Purpose and Description
Responsible for all phases of assigned workers compensation claims handling. Involved from taking initial contact to forwarding claims payment to insured. Carefully documents all claims information and maintains accurate records complying with established claim procedure requirements.
Essential Job Functions

• Secures all required claims information from contact and transcribes it for claims file and management review.

 

• Follow-up contact by telephone or by letter with claimant on initial reporting of claim. Assures that all information required to take action on claim has been submitted.

 

• Obtains information from witnesses, police, or doctors, etc., and secures medical bills or any other proof of loss required to settle claims as quickly and effectively as possible.

 

• Determines coverage and requests payment on claims handled under specified authority.

 

• Issues claims payments on claims when appropriate. Will provide required documentation to management for tracking all claims.

 

• Conducts field investigations required for prompt and equitable settlement of all assigned claims.

 

• Responsible for all claims meeting established service standards.

 

• Other duties and projects as may be assigned from time to time.

Minimum Requirements
The following are required to enable the employee to perform the essential functions of the job.

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  Skills/knowledge – Excellent communications skills (verbal and written) required, along with the ability to handle in a professional manner, claimants who may be upset or impatient. Must be able to maintain credibility with clients and develop a strong, ongoing business relationship with assigned clients. Ability to follow a task through to a timely completion is mandatory. The ability to operate a personal computer, calculator, fax, copy machine, shredder, and telephone is essential.

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  Experience/education – Minimum of one to three years in handling claims required. Workers comp/bodily injury experience preferred. Must have completed at least one AIC or AEI source or have considerable work experience. College degree required or equivalent work experience considered.