Compensation Claims Specialist

3 weeks ago


Pleasantville, New Jersey, United States VOLT Management Full time
Join Our Team as a Compensation Claims Specialist

Volt Management is seeking a dedicated Compensation Claims Specialist to enhance our team. In this pivotal role, you will:

Key Responsibilities:
  • Assess claimant eligibility and maintain communication with healthcare providers, employers, and injured parties.
  • Collaborate with claimants and their medical teams to oversee the claim process, from initial treatment to ongoing evaluations.
  • Engage with employers to support the return-to-work process, whether through full-time or modified duties.
  • Verify coverage details and ensure compliance with relevant insurance policies and legal requirements.
  • Identify opportunities for third-party recoveries, including subrogation and other potential reimbursements.
  • Manage claim reserves by accurately estimating potential liabilities and adjusting as necessary throughout the claim lifecycle.
  • Conduct thorough investigations to establish compensability status in line with jurisdictional laws.
  • Maintain an organized diary system to ensure timely case progression and optimal financial outcomes.
  • In cases of litigation, assess exposure and collaborate with legal counsel to develop robust defense strategies.
  • Ensure timely closure of claims while adhering to management's performance standards.
  • Coordinate medical treatment for injured employees, providing essential information to healthcare providers and guiding nurse case managers as needed.
  • Complete necessary payment authorization requests and comply with reporting requirements for self-insured retention.
  • Deliver exceptional customer service through direct interactions during claim reviews and meetings.

Qualifications:
  • High regard for confidentiality and ethical standards.
  • Dependable and trustworthy with a focus on accuracy.
  • Detail-oriented with a commitment to quality work.
  • Ability to follow instructions and act with sound judgment.
  • Strong organizational skills to effectively manage tasks.
  • Proficient problem-solving abilities to address issues promptly.
  • Team-oriented mindset to foster collaboration and achieve common goals.
  • Effective time management skills to meet deadlines.
  • Strong work ethic with a proactive approach.

Compensation:
The pay rate for this position ranges from $20.00 to $26.00 per hour, based on various factors including experience and qualifications.

Benefits:
Volt Management offers a comprehensive benefits package, which may include health, dental, and vision insurance, as well as retirement plans and paid leave options, subject to eligibility requirements. We are committed to fostering an inclusive workplace free from discrimination and harassment, ensuring equal opportunity for all employees.
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