Remote Workers' Compensation Claims Technician

Liberty Mutual Insurance; Glendale (CA); Hybrid; USD 52,000 - 75,000; Full time

Job summary

Liberty Mutual Insurance in California is seeking a Workers' Compensation Claims Technician to gather facts, assess claims, and manage medical information for routine workers' compensation cases.

You will communicate with injured workers, employers, and providers, authorize medical payments, and coordinate with medical management resources while maintaining accurate records. This hybrid role offers opportunities to work remotely part-time with occasional office visits within 50 miles.

Qualifications

• High school diploma plus 1-3 years' related customer service experience or applicable insurance knowledge.
• Licensing required in some states.
• Analytical skills to learn policy coverage and explain decisions.
• Strong written communication for posting files and correspondence.
• Excellent telephone and typing skills.
• Ability to use medical management resources effectively.

Responsibilities

• Conduct investigation to secure essential facts from injured worker, employer and providers regarding workers' compensation through telephone or written reports. 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.
• Provides 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 results of contacts, relevant medical reports, and duration information per file posting standards including making appropriate medical information viewable to customers in Electronic Document Management (EDM). Generates form letters following set guidelines (i.e., letters to physicians projecting disability, letters confirming medical treatment and disability and letters outlining expected outcome to employers).
• 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

Customer service

Analytical

Written communication

Telephone skills

Typing

Insurance knowledge

Education

High school diploma

Job description

Liberty Mutual Insurance in California is seeking a Workers' Compensation Claims Technician to gather facts, assess claims, and manage medical information for routine workers' compensation cases.

You will communicate with injured workers, employers, and providers, authorize medical payments, and coordinate with medical management resources while maintaining accurate records. This hybrid role offers opportunities to work remotely part-time with occasional office visits within 50 miles.