Senior Workers Compensation Claims Examiner Jobs in Pennsylvania

Experience applying laws, rules, regulations, policies, and procedures when reviewing claims for benefits

Experience adjudicating highly complex cases for benefits based on evidence.

Experience reviewing reconsideration requests or appeals for benefits.

Requires a probationary period if the requirement has not been met.

Experience making and issuing final decisions that affirm or remand cases for further development

Reviews claimant requests for reconsideration of final decisions with delegated authority to finalize or modify decisions of the initial claims examiner.

Apply your examiner, knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.

A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

Professional certification as applicable to line of business preferred.

Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations.

Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.

Confirm to the required regulatory and compliance requirements such as the HIPAA.

Confirm to the organizational and client training requirements

Demonstrate knowledge of internal operations and develops relationships to facilitate workflow.

Knowledge of related regulations and standards.

3+ years of full cycle claims processing experience in a Health Plan setting (Pay, Pend, Deny)

1+ year of experience processing claims in Facets