**Claims Specialist** **Overview: ** Are you looking for a change? Would you like to use your AZ Work Comp Claim experience in another capacity, working for an employer? If you are looking for a role that allows you to contribute to the efficient processing of insurance claims while ensuring compliance with industry standards, we encourage you to apply.
As a Claims Specialist, you will be responsible for investigating, reporting, and overseeing Work Comp claims for our clients to ensure accuracy and compliance with WC law/benefits. This role requires a strong understanding of WC laws and regulations, must be detail orientated, have great customer service, excellent data entry skills and an understanding of medical terminology.
**Responsibilities: ** - Communicate with clients, injured workers, medical providers and carriers/TPA's. Will complete new claim investigations, taking verbal statements from employees/witnesses. Prompt preparation and submission of the 101 to appropriate insurance carrier, providing relevant information obtained from employer level investigation, addressing concerns & requesting investigation for compensability as needed. Notify payroll/benefits of lost time claims if the employee has Benefits. Provide pre-injury wage information to the carrier timely when lost time is indicated. Determine if modified work is available. Maintain diary system for reviewing and overseeing existing claims to ensure benefits are paid appropriately and timely. Update clients as needed or requested. Assist WC Claim Manager with projects and oversight of WC claims. Other duties as designated by WC Claim Manager.
**Requirements: ** - Minimum 2-5 years AZ lost time adjusting experience; multi state experience is a plus. Ability to speak Spanish is a plus. Degree preferred but can be waived based on experience. Proficient with Outlook, Word, Excel. Ability to communicate well, verbally and in writing. Good working knowledge of medical terminology and WC claims processes. Need to be detail orientated and possess time management skills. Have excellent data entry skills and communication skills to interact with insurance companies and their adjusters, clients, injured employees effectively.
Job Type: Full-time
Pay: $29.00 - $32.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Flexible schedule
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday
- No nights
- No weekends
Work setting:
Education:
Experience:
- WC Claims adjusting: 2 years (Required)
- Microsoft Office: 1 year (Preferred)
- Work Comp adjuster: 2 years (Preferred)
Language:
License/Certification:
- Adjuster's license (Preferred)
Shift availability:
Ability to Commute:
- Phoenix, AZ 85012 (Required)
Ability to Relocate:
- Phoenix, AZ 85012: Relocate before starting work (Preferred)
Work Location: In person