Claims Account Specialist

2 days ago


Trenton, New Jersey, United States NJM Insurance Group Full time
Job Title: Claims Account Specialist

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
Requirements:
  • 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
Preferred Qualifications:
  • Multi-state experience and/or licensing
  • Associate's or Bachelor's degree
  • AIC/CPCU Designations
Compensation:

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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