Workers' Compensation Claims Examiner
2 days ago
We are seeking a highly skilled Workers' Compensation Specialist to join our team at the City of Jacksonville. As a key member of our Finance Department, you will be responsible for monitoring, reviewing, and processing workers' compensation claims. If you have a strong background in workers' compensation laws, rules, and regulations, and excellent communication and analytical skills, we encourage you to apply for this exciting opportunity.
Key Responsibilities- Monitor and review workers' compensation claims to ensure compliance with laws, rules, and regulations
- Investigate and process claims, including reviewing medical bills and other services for reasonableness and conformity to the appropriate medical and surgical fee schedule
- Respond to audits and manage field investigations of workers' compensation claims
- Authorize and prepare payments of approved claims
- Identify and recommend claims for subrogation and excess insurance carrier claims reporting
- Calculate and recommend workers' compensation case reserves for the Self-Insurance Fund
- Oversee and monitor rehabilitation of claimants for compliance with workers' compensation laws, rules, and regulations
- Compile data for and prepare written reports and oral presentations
- Establish and maintain workers' compensation claim files and records
- Respond to inquiries regarding workers' compensation claims and related issues
- Provide technical assistance to medical providers, lawyers, government agencies, and the general public
- Three (3) years of education, and/or experience in Workers' Compensation, General Liability, automobile liability or claims monitoring, reviewing and processing
- Florida All Lines Claims Adjuster License is required prior to appointment and must be maintained during employment in this class
The City of Jacksonville offers a comprehensive benefits package, including medical, dental, and vision plans, life insurance coverage, flexible spending plans, an employee assistance program, a 457(b) tax-deferred compensation plan, and a ROTH IRA plan. We also provide an extensive wellness program, including a health intervention program, lunch and learns, health fairs, and discounted gym memberships.
Please visit our Employee Benefits website for details on all the plans we offer.
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