Associate Claims Specialist - MO Workers Compensation

PMA Companies; Tampa (FL); On-site; USD 55,000 - 75,000; Full time

Job summary

PMA Companies in Tampa, FL is seeking an Associate Claims Specialist to manage medical-only and limited lost time workers' compensation claims. You will work to minimize losses, manage permanency files, and provide excellent customer service to accounts.

The role requires knowledge of medical terminology, strong organizational and communication skills, and the ability to handle multiple tasks independently. Licensing within 90 days and proficiency in MS Excel/Word are expected.

Qualifications

• High school diploma or equivalent.
• 1+ years of Workers Compensation claims handling experience.
• License required or ability to obtain license within 90 days of employment in mandated states.
• Familiarity with medical terminology.
• Strong organizational and communication skills.
• Proficiency MS Excel and MS Word.

Responsibilities

• Contact accounts on First Notices of Loss to obtain missing information pertinent to file set-up.
• Process payments, answer phone calls, authorize treatment associated with Medical Only claims.
• Complete appropriate contacts within 24 hours of assignment, and establish and maintain appropriate diary for follow-up.
• Determine whether treatment is appropriate and causally related to the compensable injury.
• Redirect treatment to network physicians as appropriate.
• Refer subrogation potential claims or potential permanency claims to Supervisor.
• Work to ensure compliance with all appropriate jurisdictional requirements on Medical Only claims, including timely form filing if applicable.
• Maintain a working knowledge of jurisdictional requirements and obtain/maintain state adjusting licenses.
• Administer benefits on Permanent Total or Death cases, which includes monitoring for changes in life or work status, implied interest in resolution or marked increases in costs.
• Demonstrate commitment to Company’s Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.

Skills

Organizational skills

Verbal communication

Written communication

Attention to detail

Education

High school diploma or equivalent

Tools

MS Excel

MS Word

Job description

Associate Claims Specialist - MO Workers Compensation

#4927

Tampa, Florida, United States

Job Description:

As a member of our Claims team, you will proactively manage medical only and limited lost time claims in order to minimize losses, manage permanent total claims in order to minimize losses, and provide superior customer service.

Responsibilities:

• Contact accounts on First Notices of Loss to obtain missing information pertinent to file set-up
• Process payments, answer phone calls, authorize treatment associated with Medical Only claims
• Complete appropriate contacts within 24 hours of assignment, and establish and maintain appropriate diary for follow-up
• Determine whether treatment is appropriate and causally related to the compensable injury
• Redirect treatment to network physicians as appropriate
• Refer subrogation potential claims or potential permanency claims to Supervisor
• Work to ensure compliance with all appropriate jurisdictional requirements on Medical Only claims, including timely form filing if applicable
• Maintain a working knowledge of jurisdictional requirements and obtain/maintain state adjusting licenses
• Administer benefits on Permanent Total or Death cases, which includes monitoring for changes in life or work status, implied interest in resolution or marked increases in costs.
• Demonstrate commitment to Company’s Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.

Requirements:

• High school diploma or equivalent
• One or more years of Workers Compensation claims handling experience
• License required or ability to obtain license within 90 days of employment in mandated states
• Familiarity with medical terminology
• Ability to work independently, handle multiple tasks simultaneously, make difficult decisions and focus on details
• Strong organizational skills
• Excellent verbal and written communication skills
• Proficiency MS Excel and MS Word.

Alternate Location(s)

Tampa , Florida , United States

undefined

This Company is an Equal Opportunity Employer, and does not discriminate on the basis of race, gender, ethnicity, religion, national origin, age, disability, veteran status, or on any other basis prohibited by law. Information on race, gender and national origin will only be used for statistical and recordkeeping purposes, and will not be used in making any employment decisions. All information provided will be kept separate from your expression of interest. Providing this information is strictly voluntary, and you will not be subjected to any adverse action or treatment if you choose not to provide this information. If you do not choose to answer these questions, we ask that you select "Decline to Identify" for each question. Thank you for your voluntary cooperation.

EEO is the Law ADP Privacy Statement Artificial Intelligence Google Privacy Policy Google Terms of Service