Remote Workers’ Comp Claims Technician (Medical)

Liberty Mutual Group; United States; Hybrid; USD 42,000 - 56,000; Full time

Job summary

Liberty Mutual Group is seeking a Workers' Compensation Claims Technician to process routine claims and manage ongoing medical needs. The role involves gathering information from injured workers, employers, and providers, and ensuring accurate, timely service.

The job emphasizes medical management and referral decisions, with some work-from-home capability and required in-office visits within 50 miles, twice monthly. Licensing may be needed depending on jurisdiction.

Qualifications

• High school diploma plus 1-3 years' related customer service experience or applicable insurance knowledge.
• Licensing may be required in some jurisdictions.
• Effective written skills to compose clear, succinct descriptions.
• Good telephone and typing skills.
• Ability to learn when to use medical management resources.

Responsibilities

• Investigate to secure essential facts from injured worker, employer and providers regarding workers' compensation. Verifies information from claimants, physicians, and medical providers to assess compensability and/or causal relation of medical treatment and make evaluations for cases with claim specific on-going medical management.
• Provide on-going medical case management for assigned claims. Initiates calls to injured worker and medical provider if projected disability exceeds maximum triage model projection or to resolve medical treatment issues as needed.
• Maintains contact with injured worker, provider and employer to ensure understanding of protocols and claims processing and medical treatment.
• Continually assesses claim status to determine if problem cases or those exceeding protocols should be referred to Claims Service Team and/or would benefit from, MP RN review or other medical/claims resources. Arranges Independent Medical Exam and Peer Review as necessary.
• Maintains accurate records and handles administrative responsibilities associated with processing and payment of claims. Records and updates status notes; documents result of contacts, relevant medical reports, and duration information per file posting standards including making appropriate medical information viewable to customers in EDM. Generates form letters following set guidelines.
• Authorizes payment of medical payments and/or medical treatment.
• Recognizes potential subrogation cases, prepares cases for subrogation and refers these cases to the Subrogation Units.

Skills

Written communication

Telephone skills

Typing

Medical management knowledge

Education

High school diploma + 1-3 years customer service or insurance knowledge

Job description

Liberty Mutual Group is seeking a Workers' Compensation Claims Technician to process routine claims and manage ongoing medical needs. The role involves gathering information from injured workers, employers, and providers, and ensuring accurate, timely service.

The job emphasizes medical management and referral decisions, with some work-from-home capability and required in-office visits within 50 miles, twice monthly. Licensing may be needed depending on jurisdiction.