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Senior Claims Analyst
2 weeks ago
Senior Claims Analyst
Join our dynamic team as a Senior Claims Analyst specializing in Workers Compensation claims In this role, you will be at the forefront of ensuring timely and accurate processing of medical-only workers’ compensation claims while delivering outstanding customer service. You will be entrusted with determining the appropriate amounts due to insured parties or claimants, all while adhering to our company’s policies and procedures.
This position is remote, but we strongly prefer candidates to be based in Wisconsin or nearby regions. We welcome applications from new graduates eager to launch their careers in insurance
Key Responsibilities:
- Verify, identify coverage, address compensability issues, and conduct limited investigations.
- Spot and pursue subrogation, second injury fund, and fraud cases.
- Perform timely initial and ongoing communications, investigating based on best practices.
- Maintain thorough and organized case files documenting all activities and issues.
- Obtain and analyze medical records pertinent to claims.
- Evaluate claims for necessity and relevance of treatment.
- Manage ongoing treatment cases by utilizing authorized external resources.
- Complete and submit appropriate forms to state and other agencies promptly.
- Assist in claims review and account coordination.
- Process bills and other benefit payments promptly.
- Collaborate regularly with Underwriting, Risk Engineering, and Account Executives.
- Address inquiries and concerns from insured parties, agents, state agencies, injured employees, or attorneys.
- Deliver exceptional service to agents, insureds, and others throughout the claims process.
- Consult with the claims manager or director for any settlements exceeding specified authority.
- Log all significant activities and contacts in claims files, adhering to best practices and regulations.
- Ensure completion of non-resident adjuster licenses for necessary states.
- Continue professional development through education to maintain licensure.
Your Background:
- A High School diploma with 5 years of relevant experience, or a bachelor’s degree is strongly preferred.
- Superb written and verbal communication skills.
- General knowledge of insurance or claims processing is advantageous.
- Proficiency in Microsoft Office and a willingness to learn new software.
What We Offer:
- A competitive compensation package.
- A generous 401K employer match.
- Employee Stock Purchase plan with employer matching.
- Abundant Paid Time Off.
- Comprehensive benefits focusing on the wellness of you and your family.
- Opportunities for continuous learning, including tuition reimbursement and professional training.
- A vibrant and engaging work culture that fosters career development.
- Community involvement initiatives including matching donations and volunteer opportunities.
At C&F, we believe in providing a workplace where you truly belong. If you require special accommodations, please inform us. We value diversity and inclusivity in our hiring processes and are committed to equal employment opportunities for all individuals.
