Claims Account Specialist
2 days ago
We are seeking a highly skilled Claims Account Specialist to join our team at NJM Insurance Group. As a Claims Account Specialist, you will be responsible for managing workers' compensation claims from initial intake to resolution.
Key Responsibilities:- Investigate and analyze claims to determine compensability and recommend a course of action
- Administer the delivery of timely, accurate, and appropriate indemnity and medical benefits
- Provide exceptional customer service to policyholders, injured workers, and medical providers
- Work with employers, doctors, and injured workers to develop return-to-work plans
- Recognize and investigate subrogation opportunities for recovery of third-party funds
- Collaborate with the Special Investigation Unit to identify and investigate potential fraud indicators
- Prepare and attend claim reviews as needed with the Claims Supervisor
- Participate in training programs to stay current on relevant issues and topics
- 0-3 years' experience as a Workers' Comp Claim Representative or comparable knowledge and experience
- Strong written and oral communication skills
- Sound decision-making and critical thinking capabilities
- Demonstrated organizational and communication skills
- Superior customer service skills
- Working knowledge of Microsoft Office suite of tools
- Multi-state experience and/or licensing
- Associate's or Bachelor's degree
- AIC/CPCU Designations
The salary for this position will be based on experience and credentials, with the opportunity to be filled at Level I, II, or Sr. based on the requirements listed above.
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Senior Claims Specialist
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Regional Claims Specialist
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Claims Specialist
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2 days ago
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Medical Claims Examiner
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