Workers Compensation Claims Specialist
21 hours ago
Job Title: Workers Compensation Claims Specialist
Job Summary:
Aveanna is seeking a highly skilled Workers Compensation Claims Specialist to join our team. As a key member of our claims team, you will be responsible for investigating, reviewing, and administering workers' compensation claims. You will work closely with our field staff and third-party administrators to ensure that claims are handled efficiently and effectively.
Responsibilities:
* Investigate and review workers' compensation claims to determine the extent of coverage and benefits
* Evaluate medical reports and determine the necessity of medical treatment
* Set reserves and approve or deny claims based on established protocols
* Review and approve medical bills for payment
* Interview and correspond with claimants, witnesses, attorneys, and physicians
* Represent Aveanna at workers' compensation and industrial leave claims actions and hearings
* Perform other duties as assigned
Requirements:
* High School Diploma and 5 years or more experience in Claims and Litigation OR a Bachelor's Degree and 4 years experience in Claims and Litigation
* Knowledge of claims handling and legal statutes and procedures
* Customer service experience
* Workers Comp experience in California, Texas, and Pennsylvania and non-subscriber claim experience highly preferred
Work Environment:
* Performs duties in an office environment during agency operating hours
* Must be able to function in a wide variety of environments which may involve exposure to allergens and other various conditions
Note:
This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
Vaccination Requirement:
As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate.
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