massachusetts claims examiner.
portland , oregon (remote)
posted today
job detailssummary
$34 - $35 per hour
temporary
bachelor degree
category business and financial operations occupations
referenceAB4586668
job detailsNow Hiring: Massachusetts Claims Examiner Are you ready for a life-changing opportunity? Then embrace this rewarding opportunity NOW! Apply today because openings are limited Overview To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. MA claims experience required.salary: $34 - $35 per hourshift: Firstwork hours: 8 AM - 4:30 PMeducation: BachelorsResponsibilities
Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
Negotiates settlement of claims within designated authority.
Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.
Prepares necessary state fillings within statutory limits.
Manages the litigation process; ensures timely and cost effective claims resolution.
Coordinates vendor referrals for additional investigation and/or litigation management.
Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.
Ensures claim files are properly documented and claims coding is correct.
Refers cases as appropriate to supervisor and management.
Skills
Workers Compensation Reporting Claims (3 years of experience is required)
Workers Compensation
Massachusetts Claims Handling (3 years of experience is required)
Qualifications
Years of experience: 3 years
Experience level: Experienced
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