Workers' Comp Claims Support Specialist

Emergent Holdings; Lansing (MI); On-site; USD 40,000 - 70,000; Full time

Job summary

Emergent Holdings is seeking a detail-oriented Customer Service Associate to support workers' compensation claims. You will respond to inquiries from policyholders, agents, injured workers, and providers across multiple jurisdictions, updating the claim system with critical information and ensuring timely service.

In this role you will back up claims intake, assist with document processing, and collaborate with multiple teams to resolve issues, all while maintaining compliance and quality

Qualifications

• High School Diploma or GED required and associates degree in insurance or related field preferred.
• Minimum of three years general office experience including a year in workers' compensation insurance; prior call center experience helpful.
• Strong customer service, communication, and organizational skills; ability to work with multiple systems.

Responsibilities

• Answers claim inquiries from policyholders, agents, injured workers, attorneys, pharmacies, medical providers for multiple jurisdictions; verifies claim status.
• Performs all facets of IME's, AME's, DDE's, QME's as needed for the claim file.
• Provides backup to Claims Document Analysts to review and assign document sub type.
• Reviews documents and adds pertinent information to keywords and data fields in the claim system.
• Re-indexes and routes documents to correct claim if misassigned.
• Assists with resolution of FROI errors.
• Adds legal matters and pertinent litigation information to the claim system.
• Reviews, researches, and routes unidentified claims mail for all brands.
• Provides backup to intake for multi-state claims processing.
• Produces forms, memos, reports, information and letters as requested.

Skills

Basic knowledge of insurance claims

Excellent telephone etiquette

Excellent verbal and written comms

Excellent organizational skills

Ability to multitask

Knowledge of medical terminology

Knowledge of legal terminology

Ability to train and coach others

Ability to work varied hours/days/shIF

Education

High School Diploma or GED

Associates degree in insurance or related field

Tools

ACD phone system

Document management system

Claims system software

Job description

Emergent Holdings is seeking a detail-oriented Customer Service Associate to support workers' compensation claims. You will respond to inquiries from policyholders, agents, injured workers, and providers across multiple jurisdictions, updating the claim system with critical information and ensuring timely service.

In this role you will back up claims intake, assist with document processing, and collaborate with multiple teams to resolve issues, all while maintaining compliance and quality