Senior Risk/Claims Technician

State-of-Missour; Jefferson City (MO); On-site; USD 50,000 - 70,000; Full time

Job summary

The State of Missouri is seeking a mid-level claims professional to assist injured state employees with workers' compensation claims. You will communicate with injured workers, state and public entities, medical and legal professionals, and insurers to provide one-on-one support throughout claims processing.

The role includes reviewing medical documentation, calculating benefits, and coordinating with healthcare providers under a comprehensive state benefits program.

Qualifications

• Bachelor's degree or technical experience in underwriting or administration of workers' compensation, medical, property, liability, or casualty claims.
• Knowledge of claims handling and workers’ compensation.
• Ability to interpret and explain rules, regulations, and policies.
• Ability to perform mathematical calculations, interpret data, maintain accuracy, and work independently.

Responsibilities

• Correspond with injured workers and employers.
• Calculate workers' compensation benefits.
• Review medical files and documents.
• Ensure authorized treatment in relation to an injury and approve medical bills.
• Respond to attorney requests.
• Ensure files are kept secure and confidential.
• Monitor medications of injured workers and work with pharmacy network.
• Utilize the Early Return to Work Program.

Skills

claims handling

workers’ compensation

customer service

communication

interpersonal interaction

interpret rules and policies

data interpretation

Education

Bachelor's degree / technical experience

Job description

Why you’ll love this position:

If you’re an experienced claims professional who loves working in a position that serves our state, and enjoys a work environment that is based on a sense of community, togetherness and team work, than this is the job for you! This mid-level position can be very rewarding as it will be tasked with helping injured state employees during their workers compensation claims. An individual in this position corresponds and communicates with injured workers, state and public entities, medical and legal professionals, insurance providers, and/or others, and provides one‑on‑one assistance with the processing of workers' compensation claims.

The salary indicated represents a base pay rate. If the individual selected or the position is eligible for a pay differential (e.g., shift, security, or years of service), it will be added to the total compensation in your paycheck. A pay differential does not raise your base pay.

• Correspond with injured workers and employers.
• Calculate workers' compensation benefits.
• Review medical files and documents.
• Ensure authorized treatment in relation to an injury and approve medical bills.
• Respond to attorney requests.
• Ensure files are kept secure and confidential.
• Monitor medications of injured workers and work with pharmacy network.
• Utilize the Early Return to Work Program.

Minimum Qualifications

• A Bachelor's degree from an accredited college or university and/ or technical experience in underwriting or the administration of workers compensation, medical, property, liability, or casualty claims (experience can be substituted for the education requirement)

Preferred knowledge, skills, and abilities

• Knowledge of claims handling, workers’ compensation, insurance liability, and underwriting practices.
• Skill in providing customer service, communication, and interpersonal interaction.
• Ability to interpret and explain rules, regulations, and policies.
• Ability to perform mathematical calculations, interpret data, maintain accuracy, and work independently

Lack of post-secondary education will not be used as the sole basis denying consideration to any applicant.

Successful background check results are required for employment in this position. This may include background checks involving a candidate's name and/or fingerprints and other screenings as needed for the specific position.

Authorization to work in the United States is a prerequisite of employment. The Office of Administration will not sponsor applicants for work visas.

The State of Missouri offers an excellent benefits package that includes a defined pension plan, generous amounts of leave and holiday time, and eligibility for health insurance coverage. Your total compensation is more than the dollars you receive in your paycheck. To help demonstrate the value of working for the State of Missouri, we have created an interactive Total Compensation Calculator. This tool provides a comprehensive view of benefits and more that are offered to prospective employees. The Total Compensation Calculator and other applicant resources can be found here.

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