Claims Operations Associate

Key Risk (a Berkley Company); High Point (NC); On-site; USD 42,000 - 56,000; Full time

Job summary

Key Risk, a Berkley company, is seeking an enthusiastic Claims Associate to manage low exposure workers’ compensation claims. This entry-level position requires learning workers’ compensation laws and delivering outstanding service to our clients.

No experience is necessary. You will maintain communication with employers, adjusters, and providers; discuss return-to-work status; request medical notes and proper billing information; reserve for medical-only claims; document communications; and

Qualifications

• BA/BS degree required or preferred.
• 0-2 years of workers' compensation claims experience.
• Adjuster license strongly desired or ability to obtain license within six months.
• Knowledge of workers’ compensation principles and laws, preferably jurisdiction-specific.
• Strong verbal and written communication skills.
• Strong interpersonal, time management and organizational skills.
• Strong negotiation skills.
• Attention to detail and ability to work with a sense of urgency.

Responsibilities

• Maintain good lines of communication with employers, adjusters, and providers.
• Discuss with an employer issues related to return-to-work status for injured workers.
• Request medical notes, proper billing format, and other information to determine payment responsibility.
• Timely and accurate reserve for medical-only claims.
• Document communications in the claim log notes.
• Discuss with employees issues related to bill payments or reimbursements.
• Assist in the management of unit communications with customers, providers and injured employees.
• Enter medical notes into the claim log and index images as needed.
• Identify potential subrogation claims and notify supervisor.

Education

BA/BS Degree

0-2 years experience

Job description

Company Details

With over 35 years of proven expertise in the workers' compensation industry, Key Risk delivers innovative and responsive solutions that provide our clients the freedom to do what they do best. Offering guaranteed cost options to employers nationwide, Key Risk focuses on delivering products and services within specialized verticals to reduce workers' compensation exposures and deliver industry-leading results.

All products and services are distributed through appointed insurance agents and brokers. Key Risk is a member company of W. R. Berkley Corporation, whose insurance company subsidiaries are rated A+ (Superior), Financial Size Category XV by A.M. Best Company and A+ (Strong), by S&P.

For further information about Key Risk please visit www.KeyRisk.com.

Responsibilities

Key Risk is looking for an enthusiastic Claims Associate professional who will be responsible for the management of low exposure workers’ compensation claims. The Claims Associate will be responsible for learning workers compensation laws and providing outstanding service to our clients. This is an entry-level position with no experience necessary.

• Maintain good lines of communication with employers, adjusters, and providers
• Discuss with an employer, issues relative to an injured workers’ return to work status
• Request medical notes, proper billing format, and other written/verbal information from employers and medical providers to determine appropriateness of payment of medical bills and whether a claim is truly medical only
• Timely and accurately reserve for medical only claims assigned
• Document relevant written and oral communication received relative to medical-only claims in the log notes
• Discuss with an employee, issues relative to whether a bill has been paid or whether travel or medical reimbursement has been issued
• Assist in the management of communication of the unit with customers, providers and injured employees
• Enter medical notes into claim log as required
• Index images as needed

Identify potential subrogation claims and notify appropriate supervisor.

Qualifications

Education Requirement

• BA/BS Degree

Qualifications:

Include necessary skills/experience and core competencies required

• 0-2 years of workers compensation claims experience
• Adjuster license strongly desired or ability to obtain license within six months
• Knowledge of appropriate insurance principles and laws of workers’ compensation, preferably jurisdiction specific.
• Strong verbal and written communication
• Strong interpersonal, time management and organizational skills.
• Strong negotiation skills.
• Proven critical thinking skills that demonstrates analysis/judgment and sound decision making with focus on attention to detail.
• Ability to perform with a sense of urgency.
• Ability to work both independently and within a team environment.
• Ability to travel for business purposes, approximately less than 10%.

Additional Company Details

We do not accept any unsolicited resumes from external recruiting agencies or firms.

The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.

Sponsorship Details

Sponsorship not Offered for this Role