Claims Advocate II - Workers' Comp Specialist

AF Group; Lansing (MI); À distance; USD 57 000 - 95 000; Plein temps

Résumé du poste

AF Group is seeking a mid-level Claim Representative II in Lansing, MI to handle moderate to complex workers' compensation claims. You will verify coverage, determine compensability, and assess causality to ensure proper benefits and timely settlements.

The role requires coordinating with medical providers, attorneys, and vendors, while maintaining reserves within authority and supporting return-to-work strategies under state law and company policy.

Qualifications

• Bachelor's degree or equivalent experience in a related field.
• Three years' workers' compensation claims experience or one year at AF Group Claims Representative I level.
• Strong knowledge of claims handling, investigation, and resolution processes.

Responsabilités

• Verifies workers' compensation coverage and determines compensability through thorough investigation.
• Determines causal relationship between injury and incident to ensure proper benefits.
• Facilitates return-to-work and manages medical bills related to claims.
• Establishes reserves within given authority and negotiates settlements with attorneys or claimants.
• Documents claim specifics and coordinates with vendors to control costs.
• Maintains relationships with internal and external customers and stays current on workers' compensation laws.

Connaissances

Analytical skills

Negotiation

Communication skills

Multitasking

Formation

Bachelor's degree in a related field

Outils

Claims software

Description du poste

AF Group is seeking a mid-level Claim Representative II in Lansing, MI to handle moderate to complex workers' compensation claims. You will verify coverage, determine compensability, and assess causality to ensure proper benefits and timely settlements.

The role requires coordinating with medical providers, attorneys, and vendors, while maintaining reserves within authority and supporting return-to-work strategies under state law and company policy.