Junior Workers' Comp Claims Specialist

AF - Group; Lansing (MI); On-site; USD 48,000 - 81,000; Full time

Job summary

AF - Group in Lansing, MI is seeking an entry-level claim handler for workers' compensation, focusing on medical and indemnity benefits. You will verify coverage, determine compensability, and facilitate return-to-work decisions.

The role involves establishing reserves, managing medical bills, and negotiating settlements within authority. A bachelor’s degree is preferred, with certification encouraged for career growth.

Qualifications

• Bachelor's degree or equivalent combination of education and experience required.
• One-year relevant experience or completion of claims trainee program preferred.
• Certification or progress toward certification is highly preferred.

Responsibilities

• Verify workers' compensation coverage for employers and injured employees.
• Determine claim compensability after thorough investigation.
• Assess causal relationship between injury and incident for proper benefits.
• Facilitate return to work for the injured employee.
• Establish timely reserves based on claim profile and authority.
• Document potential subrogation recovery amounts and scenarios.
• Manage medical bills for non-indemnity and indemnity claims.
• Approve payments based on treatment plans and medical evidence.
• Close files after resolution to meet performance standards and comply with law.
• Negotiate settlements within authority and involve attorneys when needed.
• Collaborate with manager on complex cases and high-stake files.
• Coordinate with outside vendors to support cost containment.

Skills

Claims knowledge

Negotiation

Investigations

Reserves

Return to work

Medical terminology

Communication

Attention to detail

Education

Bachelor's degree in a related field

Job description

AF - Group in Lansing, MI is seeking an entry-level claim handler for workers' compensation, focusing on medical and indemnity benefits. You will verify coverage, determine compensability, and facilitate return-to-work decisions.

The role involves establishing reserves, managing medical bills, and negotiating settlements within authority. A bachelor’s degree is preferred, with certification encouraged for career growth.