Claims Associate Medical only Examiner 1446749

Adecco US, Inc.; Phoenix (AZ); Remote; USD 10,000 - 60,000; Full time

Job summary

A leading staffing agency is currently seeking a Claims Associate (Medical) to analyze and manage workers' compensation claims remotely in Arizona. The ideal candidate will have a high school diploma, 1+ years of office experience, and strong communication skills. This temporary position offers a pay range of $20 - $22 per hour with benefits including medical and dental insurance.

Benefits

Medical insurance

Dental insurance

Vision insurance

401K plan

EAP program

Qualifications

• One year of general office experience or equivalent required.
• Claims industry experience preferred.
• Ability to meet or exceed performance competencies.

Responsibilities

• Adjust medical-only claims and minor lost-time workers' compensation claims.
• Support other claims representatives and examiners.
• Process workers' compensation claims determining compensability and benefits due.
• Communicate claim action with claimants and clients.

Skills

Excellent oral and written communication skills

Analytical and interpretive skills

Strong organizational skills

Good interpersonal skills

Ability to work in a team environment

Education

High school diploma or GED

Tools

Microsoft Office products

Job description

Adecco is currently assisting one of its clients in their search for a Claims Associate (Medical)

Pay range: $20 - $22/hr.

Shift availability: Remote within Arizona - 8:00 AM - 4:30PM / Monday - Friday

Duration: 3+ months (Temp)

Job Summary:

Prior medical only desk level handling is a plus/AZ license or certification is a plus

Primary purpose:

To analyze reported lower-level workers compensation claims to determine benefits due; and to ensure ongoing adjudication of claims within company standards and industry best practices.

Essential Functions and Responsibilities

• Adjusts medical-only claims and minor lost-time workers compensation claims under close supervision.
• Supports other claims representatives, examiners and leads with larger or more complex claims as necessary.
• Processes workers compensation claims determining compensability and benefits due; monitors reserve accuracy, and files necessary documentation with state agency.
• Communicates claim action/processing with claimant, client and appropriate medical contact.
• Ensures claim files are properly documented and claims coding is correct.
• May process routine payments and prescriptions and status reports for lifetime medical claims and/or defined period medical claims.
• Maintains professional client relationships.

Additional Functions and Responsibilities

• Performs other duties as assigned.
• Supports the organization's quality program(s).

Qualification

• Education & Licensing: High school diploma or GED required. Licenses as required.
• Experience: One (1) year of general office experience or equivalent combination of education and experience required. Claims industry experience preferred.
• Skills & Knowledge: Excellent oral and written communication skills, PC literate, including Microsoft Office products, analytical and interpretive skills, strong organizational skills, good interpersonal skills, ability to work in a team environment, ability to meet or exceed Performance Competencies

Work Environment

When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical: Computer keyboarding, travel as required

Auditory/Visual: Hearing, vision and talking

NOTE: Credit security clearance, confirmed via a background credit check, is required for this position.

Requirements:

Prior medical only desk level handling is a plus/AZ license or certification is a plus. 2 yrs or more of direct claim handling or applicable transferable skills in the claims industry.

Pay Details:

$20.00 to $22.00 per hour

Benefits:

Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan.

Equal Opportunity Employer/Veterans/Disabled

The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements.

• California Fair Chance Act
• Los Angeles City Fair Chance Ordinance
• Los Angeles County Fair Chance Ordinance for Employers
• San Francisco Fair Chance Ordinance

Massachusetts Candidates Only: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment.