Entry-Level Claims Associate - Workers' Comp Specialist

ViziRecruiter,LLC.; Wisconsin; On-site; USD 48,000 - 81,000; Full time

Job summary

AF Group in Wisconsin seeks an entry-level professional claims handler to manage medical and indemnity benefits. The role involves evaluating compensability, setting reserves, and negotiating settlements within authority.

Qualifications include a bachelor’s degree, plus knowledge of workers’ compensation laws, medical terminology, and strong communication skills. Bilingual abilities are preferred and essential for some cases.

Qualifications

• Bachelor’s degree in a related field or equivalent experience.
• Certification or progress toward certification is highly preferred.

Responsibilities

• Verifies workers’ compensation coverage of employers and injured employees.
• Determines compensability under workers’ compensation by thorough investigation of the claim.
• Assesses causal relationship between injury and incident to ensure proper benefits.
• Facilitates return to work for the injured employee.
• Establishes timely reserves within authority based on anticipated exposure.
• Documents specifics of claims with potential for subrogation recovery.
• Manages medical bills for non-indemnity and indemnity claims.
• Negotiates settlements with attorneys or parties within authority.
• Keeps manager informed on complex files and collaborates with outside vendors.

Skills

Computers & software

Medical terminology

WC laws & regulations

Oral & written comms

Customer service

Negotiation & conflict

Prioritization & deadlines

Attention to detail

Teamwork & independence

Education

Bachelor’s degree in related field

Certification/progress toward certification preferred

Job description

AF Group in Wisconsin seeks an entry-level professional claims handler to manage medical and indemnity benefits. The role involves evaluating compensability, setting reserves, and negotiating settlements within authority.

Qualifications include a bachelor’s degree, plus knowledge of workers’ compensation laws, medical terminology, and strong communication skills. Bilingual abilities are preferred and essential for some cases.