Claims Administrative Specialist I

Zenith Insurance Company; Los Angeles (CA); Hybrid; USD 40,000 - 50,000; Full time

Benefits offered by this job

Medical, Dental and Vision Insurance

Flexible Spending Accounts

Paid Parental Leave

Life, AD&D and Disability Insurance

401(k) and ESPP

Education and Training Reimbursement

Paid Leave: 3 weeks vacation, 2 weeks?

2 Personal Days, 2 Floating Holidays

Employee Assistance Program (EAP)

Job summary

Zenith Insurance Company seeks a Claims Admin Specialist I to perform moderate-technical administrative duties in support of the Claims function. You will ensure timely payments, coordinate medical appointments, and prepare documentation for legal and medical teams.

The role requires 2+ years of relevant experience, solid Excel and Word skills, and meticulous attention to detail. This is a hybrid Los Angeles-area position with competitive benefits and growth opportunities.

Qualifications

• High school diploma or equivalent required.
• Bachelor's degree or equivalent preferred.
• 2+ years of work-related experience; prior claims administrative support in Workers' Compensation preferred.

Responsibilities

• Issue timely and accurate allocated payments with attention to due dates.
• Calculate and issue temporary disability, wage loss, and permanent disability payments within timeframes.
• Send correct DWC notices within expected timeframes.
• Review and label Documentum.
• Process medical treatment requests via Zencare and complete follow up.
• Compile peer review packets by uploading medical records for timely treatment decisions.
• Schedule medical appointments, transportation and interpreters for injured workers and send paperwork in advance.
• Review examiner, nurse or attorney assignments before completion.
• File legal documents for attorneys through EAMS and ensure QA of documents.
• Assist nurses during the weaning process by sending notices and completing paperwork.
• Set up meetings for Examiners, Attorneys and nurses as needed.
• Maintain Claims, Medical Legal weekly staffing agenda.
• Answer calls from Examiners and respond to injured workers, Employers and brokers promptly.

Skills

Microsoft Office

Excel

Word

Grammar

Document drafting

Task management

Attention to detail

Organization

Time management

Communication

Education

High School Diploma or equivalent

Bachelor's degree or equivalent preferred

Job description

Introduction

Zenith is a team of Workers' Compensation Specialists committed to helping businesses succeed by protecting against the financial and human consequences of workplace injuries, providing for the needs of injured employees and making the workplace safer. To distinguish ourselves as the desired provider of Workers' Compensation Insurance, values such as collaboration, work-life balance, and integrity are placed at the center of all our operations. In addition, Zenith supports career advancement through a dedication to ongoing learning and development. An individual coming to Zenith will not only receive competitive compensation and a comprehensive benefits package, but continuous opportunities to grow as a professional.

Overview

Under direct supervision, the Claims Admin Specialist I performs administrative duties of moderate technical complexity in support of the Claims function. Incumbent must achieve a quality claim product on an ongoing basis by consistently applying best practices within expected timeframes completing the following tasks.

Responsibilities

• Issue timely and accurate allocated payments paying specific attention to timeframes and due dates.
• Calculate and issue Temporary disability payments, wage loss payments, and permanent disability payments within specified timeframes.
• Send correct DWC notices in compliance with expected timeframes.
• Review and label Documentum.
• Process and identify medical treatment requests through Zencare and complete follow up requests daily.
• Complete peer review packets by uploading medical records through Zencare to ensure that treatment decisions can be made timely.
• Schedule medical appointments, transportation and interpreters for injured workers and send necessary paperwork to all parties ahead of time.
• Review for accuracy, Examiner, Nurse or Attorney assignments prior to completion.
• File legal documents for attorneys through the EAMS website and ensure quality assurance of these documents.
• Assist nurses during the weaning process by sending out correct notices and completing the necessary paperwork.
• Set up meetings for Examiners, Attorneys and nurses when needed. This could include medical director staffing.
• Manage and update the Claims, Medical Legal weekly staffing agenda.
• Answer phone calls for Examiners and respond to requests from injured workers, Employers and brokers timely.
• Provide ongoing administrative support to Examiners, Attorneys and Nurses by completing work status calls, processing & formatting correspondence, and completing all paperwork and follow up phone calls timely.
• Complete all diaries within their specified time frames.
• Apply principles of logical thinking to define problems, collect data, establish facts, and draw valid conclusions.
• Work productively and harmoniously with others on a consistent basis.
• Respond positively to direction and feedback on performance.
• Consistently maintain professional and appropriate demeanor.
• Perform other duties/projects as assigned.

Education

• High School Diploma Or equivalent combination of training/experience required
• Bachelor's Degree or equivalent combination of training/experience preferred

Work Experience

• 2+ years work-related experience. Prior Claims administrative support experience preferred with preference given to experience gained in Workers' Compensation industry required

Knowledge, Skills, and Abilities

• Knowledge of Microsoft Office.
• Advanced Word and strong Excel software skills.
• Excellent spelling, punctuation and grammar skills required.
• Demonstrated ability to proficiently produce accurate final documents.
• Strong task management skills.
• High attention to detail.
• Strong organizational skills.
• Ability to manage time effectively and meet deadlines.
• Strong verbal and written communication skills.
• Strong math skills required.
• Strong customer service skills.

Pay, Benefits, and Other Information

The expected salary range for this position is $39,997 - $49,996. Actual pay will be adjusted based on experience, geographic location, and other job-related factors as permitted by law. Qualifications may warrant placement in a different job level.Benefits

• Medical, Dental and Vision Insurance
• Flexible Spending Accounts
• Paid Parental Leave
• Life, AD&D and Disability Insurance
• 401(k), Employee Share Purchase Plan (ESPP)
• Education and Training Reimbursement
• Paid Leave: 3 weeks/year Vacation, 2 weeks/year Sick Leave
• 10 paid Company Holidays, 2 Personal Days, 2 Floating Holidays
• Employee Assistance Program (EAP)
• For more information, review details on the Benefits page of our Career Site: https://www.thezenith.com/careers/benefits/

Zenith typically posts jobs for a minimum of 8 to 14 calendar days. Zenith Insurance Company is an equal opportunity employer and considers all qualified applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristic. In compliance with California law, we are committed to fair hiring practices. Pursuant to the California Fair Chance Act (AB 1008), we will consider qualified applicants with criminal histories in a manner consistent with the law. Additionally, in accordance with the Los Angeles Fair Chance Initiative for Hiring Ordinance, we will not inquire about an applicant’s criminal history until after a conditional offer of employment has been made.If you are a qualified individual with a disability or a disabled veteran and need assistance accessing our career center or applying for a position due to your disability, you are entitled to request an accommodation. To make a request, please contact a Human resources representative at Zenith Insurance Company.#LI-EF1#LI-Hybrid