Workers' Compensation Specialist

Dollar General; United States; Remote; USD 110,000 - 150,000; Full time

Job summary

Dollar General is seeking a Senior Claims Representative for remote work specializing in Workers' Compensation. The ideal candidate will investigate and manage claims, coordinate medical care, and require a college degree or equivalent experience. Strong communication skills and detail orientation are key for success in this role.

Benefits

Medical insurance

Vision insurance

401(k)

Qualifications

• Preferred college degree or equivalent experience.
• Advanced Workers Compensation claim handling background.

Responsibilities

• Investigate and resolve complex workers' compensation claims.
• Coordinate with injured employees regarding medical documentation.
• Manage requests for medical care authorization.

Skills

Detail oriented

Strong organizational skills

Excellent written communication skills

Excellent verbal communication skills

Customer service oriented

Education

College degree or equivalent experience

Tools

Microsoft Office

Job description

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Senior Claims Representative (Workers' Compensation) - Remote

General Summary:

Investigate, evaluate, negotiate, and resolve complex workers’ compensation claims within authority and with limited supervision.

Duties & Responsibilities:

• Timely conduct interviews with injured employees, customers, store personnel and medical care providers within 24 hours of receiving reported incident to evaluate facts regarding compensability of a claim under the state requirements. Maintain contact with appropriate parties throughout life of file to manage payment of appropriate benefits and mitigate exposure. Reserve claim for expected exposure, and timely document claim notes within claim system, maintaining updated action plan.
• Timely coordinate with injured employee and store personnel regarding medical documentation supporting and facilitate return to work and light duty return to work.
• Manage requests for authorization of medical care and oversee facilitation of medical care to ensure timely, appropriate, and related treatment for the work injury.
• Utilize professional judgment and experience to reserve, handle and resolve complex claims within authority and evaluate and make recommendations for reserves and action plan for resolution of claims exceeding authority.
• Provide direction to defense attorneys for claims in litigation, medical case managers and private investigators as appropriate for assigned claims.
• Develop and maintain proactive strategic plan of action for the management and resolution of claims for the life of the file.
• Maintain a working knowledge of multiple state Workers’ Compensation and statutes and maintain applicable current state licensing requirements.
• Customer service oriented and works well in a team environment.
• Excellent written and verbal communication skills.
• Strong organizational skills and the ability to prioritize complex claims.
• Must be detail oriented and able to meet deadlines.
• Ability to handle confrontational situations in a mature and professional manner.
• Working knowledge of Microsoft office programs and ability to type 40 wpm.
• Advanced knowledge of medical and legal terminology.

Work Experience &/or Education:

• College degree preferred or equivalent experience considered.
• Advanced Workers Compensation claim handling background.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Legal

• Industries

  Retail

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Inferred from the description for this job

Medical insurance

Vision insurance

401(k)

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