Claims Specialist

1 week ago


Melbourne, United States AppleOne Employment Services Full time

We are looking for a Claims Specialist to process Workers Compensation Claims


100% on site in Melbourne, FL


$20-$24/hour


Long term temp to possible perm.


This role is responsible for monitoring, coordinating, and processing Workers Compensation, Automobile and General Liability claims; this includes maintaining case history documentation, contacting, and interviewing involved parties, and serving as a technical resource to employees.


The Claims Specialist is responsible for ensuring timely processing of claims; evaluating accident reports to determine accuracy and completeness and ensuring adequate investigation. This position is also responsible for ensuring that the Company is in compliance with applicable laws and regulations and providing training and guidance, as needed.


Responsibilities:

· Monitor and record appropriate leave usage relative to Workers Compensation benefits; notify payroll and other appropriate personnel regarding adjustments

· Provide technical guidance and advice to supervisors, managers and site representatives regarding Workers Compensation, Auto Accidents and General Liability issues

· Analyze circumstances of claims, injury records and medical evaluations, accident videos and photos

· Assist Risk Manager with facilitating and coordinating program-related training as appropriate

· Prepare and maintain a variety of records, logs, correspondence, and files related to assigned activities; maintain OSHA records

· Receive, file and organize employee accident reports

· Coordinate and maintain schedules for ergonomic evaluations for employees with the ergonomic evaluator; assist the evaluator as requested

· Receive and process information on property and liability claims

· Evaluate accident reports, ensuring the timely processing of medical bills, temporary total disability benefits and deductible payments

· Review witness statements, department investigation results and other documentation and compiles facts and data regarding accident reports and filed cases

· Maintains subrogation records and files for those incidents involving third parties

· Reviews documentation to determine whether medical bills and temporary total disability benefits should be continued


Qualifications:

· High school diploma or equivalent required, college degree preferred

· Prior onboarding Workers’ Compensation & Vehicle Repair required

· Proficiency with Microsoft Office Suite (Word, Excel, PowerPoint, Outlook)

· Smartsheets or other EHS platforms

· Detailed oriented, Troubleshooting, Problem solving, Work independently, Time management, good Communication skills

· Prior work with TPA’s and Liability Insurance carriers

· Excellent organization and time management skills to handle multiple tasks in an environment with large volumes of data and paperwork

· Ability to interpret, apply and explain Workers Compensation coverage and benefits to employees

· Ability to maintain confidentiality with sensitive data

· Ability to establish and maintain comprehensive records and prepare reports

· Ability to interpret, apply and explain applicable laws, codes, rules and regulations

· Ability to analyze facts, information, and data


Apply today



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