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Claims Administrative Specialist

4 weeks ago


Los Angeles, California, United States Zenith Full time
{"title": "Claims Administrative Specialist", "description": "Job Summary

Zenith Insurance Company is seeking a highly skilled Claims Administrative Specialist to join our team. In this role, you will provide administrative support to our claims team, ensuring the efficient processing of claims and excellent customer service.

Key Responsibilities
  • Issue timely and accurate allocated payments, paying specific attention to timeframes and due dates.
  • Calculate and issue Temporary disability payments, wage loss payments, and permanent disability payments within specified timeframes.
  • Send correct DWC notices in compliance with expected timeframes.
  • Review and label Documentum.
  • Process and identify medical treatment requests through Zencare and complete follow-up requests daily.
  • Complete peer review packets by uploading medical records through Zencare to ensure that treatment decisions can be made timely.
  • Schedule medical appointments, transportation, and interpreters for injured workers and send necessary paperwork to all parties ahead of time.
  • Review for accuracy, Examiner, Nurse, or Attorney assignments prior to completion.
  • File legal documents for attorneys through the EAMS website and ensure quality assurance of these documents.
  • Assist nurses during the weaning process by sending out correct notices and completing the necessary paperwork.
  • Set up meetings for Examiners, Attorneys, and nurses when needed.
  • Manage and update the Claims, Medical Legal weekly staffing agenda.
  • Answer phone calls for Examiners and respond to requests from injured workers, Employers, and brokers timely.
  • Provide ongoing administrative support to Examiners, Attorneys, and Nurses by completing work status calls, processing & formatting correspondence, and completing all paperwork and follow-up phone calls timely.
Requirements
  • High School Diploma or equivalent required.
  • Bachelor's Degree or equivalent combination of training/experience preferred.
  • 2+ years work-related experience prior to Claims administrative support experience preferred, with preference given to experience gained in the Workers' Compensation industry required.
  • Knowledge of Microsoft Office required - possessing advanced Word and Excel software skills.
  • Excellent spelling, punctuation, and grammar skills required.
  • Work experience demonstrating ability to proficiently produce accurate final documents.
  • Strong verbal and written communication skills.
  • Strong math skills required.
  • Good organizational skills.
What We Offer

Zenith Insurance Company offers a competitive salary range of $49,867.95 to $56,380.92, with actual pay adjusted based on experience, geographic location, and other job-related factors as permitted by law. We are an equal opportunity employer and welcome applications from all qualified individuals without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.

", "lang_code": "en"}