Workers Comp Coord

3 weeks ago

Le Mars, United States Wells Enterprise Full time
Job Description

Under general direction, ensures the timely processing of Workers Compensation claims. Evaluates information to determine accuracy, completeness and proper submission. Point of contact for internal and external business partners.
  • 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.
Qualifications

In addition to the responsibilities listed above, other duties may be assigned by your supervisor, as dictated by business necessity.
  • 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


Wells Enterprises is an EEO/AA employer M/F/Vet/Dis

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