Workers' Comp Claims Assistant
Location: Reno, Nevada
Description: Hometown Health is currently interviewing Workers' Comp Claims Assistant right now, this occupation will be presented in Nevada. For complete informations about this occupation opportunity kindly see the descriptions. Position Purpose:
Under the direction of the Director, Self-Funded Operations and/or the Workers Compensation Claims Manager and/or Supervisor, the Claims Assistant i! s responsible for administratively supporting the Claims Examiner and facilitating all non-Claims Examiner functions necessary to comply with internal best practices, and State and Federal Regulations with the goal of assuring a positive claims cost outcome for all parties.
Nature and Scope:
Assist with and document regular communications with injured works, medical providers, attorneys, employers, etc. to expedite medical recovery, return to work and claim closure protocols.
Assist clients to assure return to work program compliance, communicate medical status and recovery plans, and coordinate any other issues that require day-to-day interaction.
Submit claimant eligibility information to pharmacy benefits manager upon claim acceptance and closure.
Responsible for the processing of all medical bills related to the injured worker by applying the appropriate State Fee Schedule, any contracted fee schedules with network provider! s and coordinating return of denied bills. Administer payments! for mileage reimbursement, medication reimbursements, etc.
Responsible for conducting preliminary check run to identify and resolve any errors prior to final check issuance.
Assist Claims Examiners with set-up of claimant files, file preparation for provider and/or attorney reviews, creation of hearing statement and packet for State Hearing Officer on behalf of client, maintenance of current claim status information in the claims management system.
Assure all documents are scanned, indexed and attached to the claim file daily.
Generate various reports applicable to managing clients’ workers compensation claims such as open and closed claim reports, excess loss reports, etc.
This position does not provide patient care.
This position does not provide patient care.
The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work co! nditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.
Minimum Qualifications: Requirements - Required and/or Preferred
Education:
Must have working-level knowledge of the English language, including reading, writing and speaking English.
Experience:
One or more year of experience in a workers’ compensation claims office providing claims support, including on-line claims adjudication.
License(s):
None.
Certification(s):
None.
Computer / Typing:
Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.
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If you were eligible to this occupation, please send us you! r resume, with salary requirements and a resume to Hometown Health.
Interested on this occupation, just click on the Apply button, you will be redirected to the official website
This occupation starts available on: Wed, 27 Mar 2013 17:51:45 GMT
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