Medical Claims Representative

3 weeks ago


Minneapolis, United States Robert Half Full time
Job DescriptionJob Description

We are offering a remote opportunity for a Worker's Compensation Claims Representative. In this role you will be handling various tasks related to claim administration, customer communication, and compliance with state regulations.


Responsibilities:

• Experience and knowledge of Minnesota and Wisconsin-based workers' compensation claims.

• Accurately process and confirm policy coverage for received claims.

• Investigate claim information and file necessary documentation with relevant state agencies.

• Manage and document action plans to minimize the overall cost of the claim.

• Handle subrogation and litigation of claim as applicable.

• Oversee potential claim recoveries of all types.

• Maintain detail oriented relationships with customers and communicate claim statuses.

• Adhere to client and carrier guidelines and participate in claims review as needed.

• Utilize Microsoft Office including Excel spreadsheets to maintain accurate customer credit records.

• Assist team members in developing knowledge and understanding of claims practice.

• Comply with rules and regulations of the applicable state.

• Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets

• 2 years of worker's compensation claims experience

• Skilled in handling Appeals

• Understanding of Benefit Functions

• Proficient in Billing Functions

• Experience in Claim Administration

• Ability to manage Collection Processes


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