Claims Assistant

2 weeks ago

Lewisville, United States Method Insurance Services Full time
Who We Are

Method Workers' Compensation is a portfolio of workers' comp companies with the same mission: minimizing the human and financial cost of workplace injuries. We mitigate workplace injuries and deliver exceptional healthcare outcomes for injured workers, expediting a return to work, preserving families' livelihoods, and enhancing employers' productivity. We maintain in-house expertise in claims management, medical bill review, underwriting, and loss prevention for high-hazard, high-mod, and mid-market risks. From submission to claim, we're there every step of the way, improving outcomes for everyone involved. Method currently operates in all states.

What To Expect

The Claims Assistant is primarily responsible for providing administrative support to the claims compliance team and adjusters. This role is also responsible for responding to requests for general claims information. This is a full-time, hourly non-exempt position with standard business hours of Monday through Friday from 8:00am to 5:00pm, with some flexibility at manager's discretion.

What You'll Do
  • Complete new claim set up by entering the claim and policy information into the claims system of record, ensuring the accurate policy is referenced, and accurate information is entered to set up the claim as well as evaluating the claim jurisdiction and severity to determine claim assignment.
  • Locate the correct policy and communicate with the supervisor if unable to locate it.
  • Prepare correspondence accurately, including required state forms and letters, correspondence to stakeholders, requests for medical records, or other information.
  • Enter medical or expense payments into the claims system.
  • Research outstanding indemnity, expense, and medical checks and submit void, stop pay, and re-issuance requests.
  • Enter attorney and child support entries into the claims system.
  • Review, evaluate & calculate mileage and travel reimbursement requests and issue payment based on state-specific requirements.
  • Prepare medical records and attorney referral packets.
  • Receive and make calls to medical providers, policyholders, and employees.
  • Request information from other identities based on ISO search research.
  • Request W-9 from medical providers and other external vendors.
  • Send proof of payments and explanation of review upon request.
  • Register policyholders for state MPN including obtaining policyholder confirmation of posting notices if/when required.
  • Support external audits by obtaining and providing required documentation.
  • Perform other duties as requested and assigned.
Requirements

What You Need
  • General knowledge and understanding of the insurance industry and/or related fields or products
  • Ability to think critically, solve problems, plan, and organize activities
  • Must have professional telephone etiquette and be customer service oriented
  • Demonstrate strong prioritization skills by proactively managing day-to-date tasks with strong organizational skills
  • Detailed oriented with the ability to work in a team environment
  • Proficient in Microsoft Office Suite, PDF Professional, G Suite, or similar software.
  • A high school diploma or GED required
  • Licenses as required
Preferred Experience
  • At least 2 years of related experience
  • Customer service, insurance, or claims experience
  • Notary public registration


What We Offer:

In exchange for your time and expertise, we offer competitive compensation, 401(k) plus matching, health benefits (including HSA Contribution), paid disability, paid parental leave, professional development opportunities, and a hybrid/remote work environment. This is an opportunity to play a key role in the continued success of a growing organization.

Unless fully remote, this position operates in a professional office setting and routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets, and fax machines. This is largely a sedentary role with prolonged periods of sitting at a desk and working on a computer. However, some filing is necessary and may require the ability to lift files, open filing cabinets and bend or stand on a stool as necessary.

Method Workers' Compensation is an equal opportunity employer regardless of race, color, gender, age, sexual orientation, gender identity, gender expression, religious beliefs, marital status, genetic information, national origin, disability, protected veteran status, or any other basis protected by federal, state, or local law.

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