Claims Support Specialist I

1 week ago


Glendale, California, United States Intercare Holdings Insurance Services, Inc. Full time

Job Type:
Full-time

Position Overview:
This role reports directly to the Claims Supervisor of the unit while receiving primary guidance from the designated Claims Specialist(s). The individual is accountable for delivering administrative support to the assigned Claims Specialist(s).

Key Responsibilities:

  • Establishes new claims documentation
  • Calculates Temporary Total Disability (TTD), Wage Loss, Vocational Rehabilitation Maintenance Allowance (VRMA), and Permanent Disability (PD) benefits
  • Processes compensation disbursements according to the diary schedule
  • Issues Benefit Notifications
  • Conducts calls to medical professionals for status updates and communicates with employees and employers
  • Contacts employers to verify light duty or modified work arrangements
  • Collaborates closely with Claims Specialist to fulfill clerical tasks
  • Prepares legal documents including Compromise and Release (C&R), Stipulations, and Answers
  • Completes rehabilitation documentation for submission to the rehabilitation department
  • Handles inquiries from providers regarding outstanding invoices and billing issues
  • Reviews incoming mail and processes direct payment requests such as Mileage Reimbursement
  • Performs filing and serving duties as required
  • Documents notes in the Portal

Competencies:
To excel in this position, candidates should exhibit the following skills:

  • Problem Solving: Effectively identifies and resolves issues promptly; adept at gathering and analyzing information; generates alternative solutions; collaborates well in group problem-solving scenarios.
  • Customer Service: Handles challenging or sensitive customer interactions; responds swiftly to customer needs; seeks customer feedback to enhance service; fulfills service requests and commitments.
  • Team Collaboration: Encourages and supports the success of all team members.

Qualifications:
To be successful in this role, individuals must be capable of performing each essential duty effectively. The qualifications outlined below represent the necessary knowledge, skills, and abilities required. Reasonable accommodations may be provided to enable individuals with disabilities to perform essential functions.

Education and Experience:
A high school diploma or equivalent (GED); or 1-2 years of relevant experience and/or training; or a combination of education and experience that is equivalent.



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