Claims Assistant - Workers' compensation

TRISTAR RISK MANAGEMENT; Irving (TX); On-site; USD 25,000 - 29,000; Full time

Job summary

Paycom - ATS is seeking an entry-level administrative assistant to provide clerical and data-entry support for workers’ compensation claims in a Dallas–Irving, TX office. You will assist Claims Examiners with claim setup, correspondence, and required filings while maintaining records and deadlines.

Responsibilities include entering new claim information, processing payments under supervision, and handling mail, reports, and document organization.

Qualifications

• High school diploma or GED required.
• One year of experience in workers’ compensation claims preferred.
• Must type at least 45 words per minute.

Responsibilities

• Enter new claim information and establish claim files in the system.
• Assist Claims Examiners with light-duty claim communications.
• Support payment processing under Claims Examiner direction.
• Prepare notices and state filings.
• Organize mail and prepare outgoing correspondence.

Skills

Typing 45 wpm

Medical/Legal terminology

Document organization

Microsoft Word

Education

High School Diploma or GED

Tools

Microsoft Word

10-key calculator

Job description

Job Details: Level: Entry, Job Location: Dallas - Irving, TX 75038, Position Type: Full Time, Education Level: High School Diploma or GED, Salary Range: $18.26 - $20.67 Hourly, Travel Percentage: None, Job Shift: Day, Job Category: Admin - Clerical,

POSITION SUMMARY

Under close supervision, provides clerical, administrative, and data-entry support for the administration of workers’ compensation claims. Supports Claims Examiners with claim setup, payment processing, correspondence, regulatory filings, and records maintenance.Communicates regularly with claimants, medical providers, employers, investigators, attorneys, management, and TRISTAR staff. Completes assigned tasks in accordance with established procedures and Claims Examiner instructions and refers matters requiring claims decisions or authorization to the appropriate Claims Examiner or supervisor.

DUTIES AND RESPONSIBILITIES

• Enters new claim information and establishes claim files in the claims management system.
• Assists with telephone communications concerning light-duty claims, as directed by Claims Examiners.
• Supports scheduled payment processing under the direction of a Claims Examiner.
• Processes special mailing requests in accordance with instructions and applicable deadlines.
• Prepares PLN notices and other state filings using information provided or approved by Claims Examiners.
• Assists with mail processing and check printing, as needed.
• Enters payments as directed by authorized claims staff.
• Receives, organizes, and distributes incoming mail and prepares outgoing correspondence and claim-related documents.
• Copies, scans, and organizes documents as directed.
• Answers and routes telephone calls, records messages accurately, and directs inquiries to the appropriate staff member.
• Prepares, generates, and runs reports from the claims management system, as requested.
• Maintains accurate records and promptly reports missing information or processing discrepancies.
• Performs other duties as assigned.

EQUIPMENT OPERATED/USED

Computer, telephone, 10-key calculator, fax machine, printers, and other standard office equipment.

SPECIAL EQUIPMENT OR CLOTHING

Appropriate office attire.

Qualifications

QUALIFICATIONS REQUIRED:

Education/Experience

High school diploma or GED required. One (1) year of experience in the workers’ compensation claims industry is preferred.

Knowledge, Skills and Abilities

• Demonstrated keyboarding proficiency, with the ability to type at least 45 words per minute.
• Working knowledge of medical and legal terminology.
• Ability to alphabetize, collate, and organize documents accurately.
• Proficiency in Microsoft Word.
• Ability to follow written and verbal instructions from multiple staff members and seek clarification when priorities conflict.
• Strong attention to detail and a demonstrated ability to produce accurate work.
• Effective written and verbal communication skills.
• Professional and courteous telephone communication skills.
• Ability to prioritize multiple assignments and meet established deadlines.
• Ability to complete assigned tasks independently within established procedures and to collaborate effectively with the workgroup.
• Positive, service-oriented approach to supporting claims staff and resolving administrative matters.

Other Qualifications

Certification and/or licensure as required by applicable state regulations.

Mental and Physical Requirements

Mental and Physical Requirements: [see separate attachment for a copy of checklist of mental and physical requirements]MENTAL AND PHYSICAL REQUIREMENTS1. MENTAL EFFORTa. Reasoning development:Follow one- or two-step instructions; routine, repetitive task.Carry out detail but uninvolved written or verbal instructions; deal with a few concrete variables.Follow written, verbal, or diagrammatic instructions; several concrete variables.Solve practical problems; variety of variables with limited standardization; interpret instructions.X Logical or scientific thinking to solve problems; several abstract and concrete variables.Wide range of intellectual and practical problems; comprehend most obscure concepts.b. Mathematical development:Simple addition and subtraction; copying figures, counting, and recording.Add, subtract, multiply, and divide whole numbers.X Arithmetic calculations involving fractions, decimals, and percentages.Arithmetic, algebraic, and geometric calculations.Advanced mathematical and statistical techniques such as calculus, factor analysis, and probability determination.Highly complex mathematical and statistical techniques such as calculus, factor analysis, and probability determination; require theoretical application.c. Language development:Ability to understand and follow verbal or demonstrated instructions; write identifying information; request supplies verbally or in writing.Ability to file, post, and mail materials; copy data from one record to another; interview to obtain basic information such as age, occupation, and number of children; guide people and provide basic direction.Ability to transcribe dictation; make appointments and process mail; write form letters or routine correspondence; interpret written work instructions; interview job applicants.Ability to compose original correspondence, follow technical manuals, and have increased contact with people.X Ability to report, write, or edit articles for publication; prepare deeds, contracts or leases, prepare and deliver lectures; interview, counsel, or advise people; evaluate technical data.2. PHYSICAL EFFORTa. Physical activity required to perform the job:X Sedentary work: Exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally, and all other sedentary criteria are met.Light work:a. Exerting up to 20 pounds of force occasionallyb. Exerting 10 pounds frequentlyc. Exerting a negligible amount of force constantly to move objects(If the use of arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most of the time, the job is rated for Light Work).Medium work:a. Exerting up to 50 pounds of force occasionallyb. Exerting up to 20 pounds of force frequentlyc. Exerting 10 pounds of force constantly to move objectsHeavy work:a. Exerting up to 100 pounds of force occasionallyb. Exerting up to 50 pounds of force frequentlyc. Exerting 20 pounds of force constantly to move objectsVery heavy work:a. Exerting in excess of 100 pounds of force occasionallyb. Exerting in excess of 50 pounds of force constantly to move objectsc. Exerting in excess of 20 pounds of force constantly to move objectsVisual requirements necessary to perform the job:Far vision: clarity of vision at 20 feet or moreX Near vision: clarity of vision at 20 inches or lessX Mid-range vision: clarity of vision at distances of more than 20 inches and less than 20 feetDepth perception: the ability to judge distance and space relationships, so as to see objects where and as they actually areColor vision: ability to identify and distinguish colorsField of vision: ability to observe an area up or down or to the right or left while eyes are fixed on a given point2. PHYSICAL EFFORT (cont.)FREQUENCYc. Physical activity necessary to perform the job and frequency (e.g., continually, frequently, or occasionally):Climbing: Ascending or descending ladders, stairs, scaffolding, ramps, poles, and the like, using feet and legs and/or hands and arms. Body agility is emphasized. This factor is important if the amount and kind of climbing required exceeds that required for ordinary locomotion.Balancing: Maintaining body equilibrium to prevent falling when walking, standing, or crouching on narrow, slippery, or erratically moving surfaces. This factor is important if the amount and kind of balancing exceeds that needed for ordinary locomotion and maintenance of body equilibrium.Stooping: Bending body downward and forward by bending spine at waist. This factor is important if it occurs to a considerable degree and requires full use of the lower extremities and back muscles.Kneeling: Bending legs at knee to come to a rest on knee or knees.Crouching: Bending the body downward and forward by bending legs and spine.Crawling: Moving about on hands and knees or hands and feet.Reaching: Extending hand(s) and arm(s) in any direction.Standing: Particularly for sustained periods of time.Walking: Moving about on foot to accomplish tasks, particularly for long distances.Pushing: Using upper extremities top press against something with steady force in order to thrust forward, downward, or outward.Pulling: Using the upper extremities to extend force in order to drag, haul, or tug objects in a sustained motion.Foot Motion: Using feet to push pedals.Lifting: Raising objects from a lower to a higher position or moving objects horizontally from position to position. This factor is important if it occurs to a considerable degree and requires substantial use of the upper extremities and back muscles.X Fingering: Picking, pinching, typing, or otherwise working with fingers rather than with the whole hand or arm as in handling.X Grasping: Applying pressure to an object with the fingers and palm.FrequentlyOccasionally2. PHYSICAL EFFORT (cont.)FREQUENCYX Talking: Expressing or exchanging ideas by means of the spoken word. Those activities in which workers must convey detailed or important spoken instructions to other workers accurately, loudly, or quickly.X Hearing: Perceiving the nature of sounds with or without correction. Ability to receive detailed information through verbal communication and to make fine discriminations in sound, such as when making find adjustments on machined parts.Feeling: Perceiving attributes of objects, such as size, shape, temperature or texture by touching with skin, particularly that of fingertips.X Repetitive Substantial movements (motions) of the wrists, hands,Motion: and/or fingers.FrequentlyFrequentlyFrequently3. WORKING CONDITIONSDisagreeable job conditions to which the employee may be exposed and the frequency (e.g., continually, frequently, or ...)WORKING CONDITIONENVIRONMENTALFACTORENVIRONMENTALNATURE/REASONOFOther (specify):