Medical Only Claims Trainee: Path to Specialist

Emergent Holdings, Inc.; Lansing (MI); Sur place; USD 42 000 - 62 000; Plein temps

Résumé du poste

Emergent Holdings, Inc. in Lansing is seeking an entry-level Medical Only Claims Associate to support the Medical Only Claims team.

This 12-month training position advances toward the Medical Only Claims Specialist I after successful completion of the plan. The role involves assisting with investigation and management of workers’ compensation claims, directing care, evaluating medical reports, and coordinating with internal and external stakeholders to ensure timely, compliant handling and cost

Qualifications

• High school diploma or equivalent required; related experience considered.
• Associates degree in insurance, business administration, health administration, or related field preferred.
• Combination of education and experience may be considered in lieu of a degree.

Responsabilités

• Assist with investigation and management of workers' compensation claims.
• Assist with determining and managing ongoing medical treatment programs including directing care, creating panels, and approving provider requests.
• Evaluates medical reports and correspondence for appropriate action/documentation.
• Supports customer service for the multi-functional claims team; coordinates with team members for timely handling of claims in other states.
• May backup MOCS for verifying workers’ compensation coverage of employers and injured employees.
• Documents specifics of claims with potential for subrogation and approves payments based on treatment plans.

Connaissances

Insurance operations

Verbal & written communication

Multifunctional teamwork

Diplomacy & discretion

Organization & prioritization

Math & analytical skills

Proofreading

Medical terminology

Formation

High school diploma

Associates degree in insurance / business / health administration

Description du poste

Emergent Holdings, Inc. in Lansing is seeking an entry-level Medical Only Claims Associate to support the Medical Only Claims team.

This 12-month training position advances toward the Medical Only Claims Specialist I after successful completion of the plan. The role involves assisting with investigation and management of workers’ compensation claims, directing care, evaluating medical reports, and coordinating with internal and external stakeholders to ensure timely, compliant handling and cost