Workers Compensation Expert
7 days ago
About the Role
Gallagher is seeking a highly skilled and experienced Insurance Claims Specialist to join our team. As a key member of our managed care team, you will play a critical role in guiding our clients and claimants to the best possible outcomes for their health and wellbeing.
Key Responsibilities
- Maintain and develop various programs, including medical bill processes, PPO/Specialty Networks, pharmacy processes, case management processes, and customer service/litigation issues.
- Sustain continuous communication with managed care vendors to ensure all service program expectations are identified and maintained.
- Manage questions/issues from internal and external users relating to managed care programs, processes, and interfaces.
- Resolve and troubleshoot service issues through appropriate channels.
- Develop and enhance existing managed care workers compensation programs.
- Direct vendor activity, including authorization of fee application and impact to clients funding mechanisms.
- Participate in client and/or vendor meetings.
- Exercise decision-making authority on client fees and credits of significant value.
Requirements
- Bachelor's degree.
- 3 years' of direct insurance industry experience.
- General knowledge of workers compensation managed care industry.
- Excellent written and oral communication skills.
- Strong organizational skills, with the ability to prioritize workload and manage multiple tasks simultaneously.
- Ability to travel up to 20%.
Preferred Qualifications
- Proficiency in computer applications, including Outlook, Excel, Word, PowerPoint, and Access.
- Familiarity with Access or enterprise database programs.
Benefits
- Competitive salary.
- Great teams and exciting career opportunities.
- Medical/dental/vision plans, which start from day one.
- Life and accident insurance.
- 401(K) and Roth options.
- Tax-advantaged accounts (HSA, FSA).
- Educational expense reimbursement.
- Paid parental leave.
- Digital mental health services (Talkspace).
- Flexible work hours.
- Training programs.
- Gallagher Thrive program.
- Charitable matching gift program.
About Gallagher
Gallagher is a leading provider of insurance and risk management solutions. We value inclusion and diversity, and are committed to creating a workplace that is welcoming and inclusive for all employees. We believe that all persons are entitled to equal employment opportunity and prohibit any form of discrimination based on protected characteristics.
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