Associate Claim Specialist

3 weeks ago

Maine, United States Opportunities at MEMIC Full time
Job Opportunity at MEMIC

We are seeking a highly skilled and detail-oriented Associate Claim Specialist to join our team at MEMIC. As a key member of our claims team, you will be responsible for investigating, evaluating, and resolving medical only and lost time claims.

Key Responsibilities:

  • Communicate with insureds, injured workers, agents, brokers, witnesses, attorneys, loss prevention, and underwriters to obtain and relate necessary information.
  • Administer the delivery of timely, appropriate medical and indemnity benefits.
  • Evaluate claim exposure, investigate, negotiate, and resolve medical only and lost time claims.
  • Maintain quality claim files in accordance with best practices, company policy, procedures, and state workers' compensation statutes.
  • Implement Managed Care strategies, coordinate rehabilitation or medical management, process bills, review all mail through ImageRight, and monitor progress as appropriate.
  • Interact with State and Federal Boards and Commissions, while establishing and maintaining proper reserves as necessary.
  • Stay up-to-date on State laws and Company procedures relating to various claims and educate injured workers and/or insured on the same.
  • Participate in in-house and outside training programs to keep up-to-date on relevant issues/topics.
  • Understand medical terminology and standard medical procedures as they pertain to workers' compensation.
  • Maintain a working knowledge of all computer systems currently in use.
  • Travel throughout states as required for handling claims inventory assigned.
  • Continues education in claims through WCP, Associate in Claims, or Claims Law (AEI) courses.

Requirements:

  • No previous experience needed; on-the-job training provided.
  • Proficient in Microsoft Office (Word and Excel).
  • Must have a valid driver's license.
  • Strong attention to detail and strong verbal and written communication skills are a must.
  • Must have flexibility and be self-directed with the ability to manage time and other resources wisely.
  • Must have the ability to work effectively with other organizational team members.
  • If jurisdiction requires, obtain required adjuster licenses within 6 months of employment, or earlier, at manager discretion. Additional licenses may be required throughout the course of employment.

Benefits:

  • Comprehensive benefits package including health insurance options, dental insurance options, vision insurance, employee life insurance/AD&D, and dependent life insurance options.
  • Short-term and long-term disability, health savings account with potential employer match, flexible medical and dependent care account, accident insurance, critical illness insurance, employee assistance program, legal/identity theft insurance options, and long-term care insurance.
  • 401(k) retirement plan with match up to 5%, plus profit sharing and discretionary contributions (subject to vesting).
  • Four weeks of paid time off (PTO) and 10 paid holidays.
  • Flextime schedules, paid parental leave, student loan paydown and refinancing assistance, educational assistance for job-related courses, seminars, certifications, or degrees, one paid day every year to volunteer for your non-profit of choice, on-site fitness center (Maine and Virginia) or fitness reimbursement, subsidized parking, and sit-stand desks and daily stretch breaks.

MEMIC is an Equal Opportunity Employer.

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