Entry-Level Claims Specialist (Workers’ Comp)

Blue Cross Blue Shield of Michigan; Northern (KY); Hybrid; USD 48,000 - 81,000; Full time

Job summary

AF Group in Wisconsin, USA is recruiting for an entry-level professional claims handler specializing in medical and indemnity benefits. The role requires evaluating compensability, reserves, and settlements within authority, while adhering to state laws and internal standards.

Office-based with minimal travel and strong attention to detail are essential. The compensation and benefits package reflects internal equity, candidate skills, and market factors, with an estimated pay range of $48,200 to

Qualifications

• Bachelor’s degree in a related field. Continuous learning, as defined by the company’s learning philosophy, is required.
• Knowledge of medical and legal terminology related to the work.
• Effective oral and written communication skills.
• Ability to negotiate, build consensus and resolve conflict.

Responsibilities

• Verifies workers’ compensation coverage of employers and injured employees.
• Determines compensability under workers’ compensation by thorough investigation of the claim.
• Determines causal relationship between the reported injury and the incident to ensure appropriate payment of benefits.
• Facilitates return to work for the injured employee.
• Establishes timely and appropriate reserves based on the profile of the claim within given authority based on anticipated financial exposure.
• Documents specifics of claims with potential for subrogation recovery, including amount of potential recovery monies.
• Manages medical bills for non-indemnity and indemnity claims directly associated with the claimed injury.

Skills

Bachelor's degree required

Computer literacy

Medical terminology

Negotiation

Communication

Education

Bachelor’s degree in a related field

Tools

Company standard software

Job description

AF Group in Wisconsin, USA is recruiting for an entry-level professional claims handler specializing in medical and indemnity benefits. The role requires evaluating compensability, reserves, and settlements within authority, while adhering to state laws and internal standards.

Office-based with minimal travel and strong attention to detail are essential. The compensation and benefits package reflects internal equity, candidate skills, and market factors, with an estimated pay range of $48,200 to