Experienced Workers Compensation Claim Representative Jobs

Communicate with manager on claims above authority granted.

Participate in OR's Managed Care Excellence Group as requested.

Ensure TPA compliance with our best claim practices.

Provide direction to TPA as needed.

Act as liaison between insureds and TPA as needed.

Review/ approve reserves on assigned claims.

Knowledge of all lower level claim position responsibilities.

Career development: CCMSI offers robust internships and internal training programs for advancement within our organization.

Provide education, training and assist in the development of claim staff.

Excellent oral and written communication skills.

Good analytic and negotiation skills.

Must be detail oriented and a self-starter with strong organizational abilities.

Maintain Continuing Education requirements as required.

Apply knowledge to determine causal relatedness of medical conditions.

If controverted or coverage is unconfirmed, retain and manage assigned claims to conclusion.

Proactively manage inventory with documented plans of action to ensure timely and appropriate file closing or reassignment.

Manage litigation to drive files to an optimal outcome.

3+ years Workers Compensation claim handling experience preferred.