Remote Claims Representative - Workers' Compensation

About the Role

We are seeking a dedicated Remote Claims Representative to join our team specializing in Workers' Compensation claims. In this role, you will manage claims from inception to resolution, ensuring compliance with legal standards and company policies. As a Remote Claims Representative, you will play a crucial role in providing exceptional customer service while navigating the complexities of claims management.

What You'll Do

• Handle incoming claims inquiries and provide accurate information to clients regarding their Workers' Compensation claims.
• Evaluate claims to determine eligibility and assess the extent of liability.
• Communicate effectively with clients, medical providers, and legal representatives to gather necessary documentation and information.
• Utilize your negotiation skills to settle claims efficiently while maintaining compliance with industry regulations.
• Document all interactions and decisions in the claims management system to ensure transparency and accuracy.
• Collaborate with team members to improve processes and enhance customer satisfaction.
• Stay updated on industry trends and changes in Workers' Compensation laws to provide informed guidance.
• Participate in training programs to enhance your skills as a Remote Claims Representative.

Requirements

• Minimum of 2 years of experience in claims handling, specifically in Workers' Compensation.
• Strong understanding of medical terminology and claims management processes.
• Excellent organizational and problem-solving skills.
• Proficient in conflict resolution and communication, both verbal and written.
• Ability to analyze data and make informed decisions based on findings.
• Experience with legal compliance and litigation processes is a plus.
• High level of professionalism and integrity in handling sensitive information.
• Ability to work independently in a remote environment.

Nice to Have

• Certification in claims adjusting or related field.
• Familiarity with claims management software.
• Experience in customer service within the insurance industry.

What We Offer

• Competitive salary ranging from $60,000 to $80,000 annually.
• Comprehensive benefits package including medical, vision, and dental insurance.
• Generous PTO plan and paid company holidays.
• Education Assistance Program for tuition reimbursement after 6 months of service.
• 401(k) plan with company match and immediate vesting.
• Wellness initiatives including fitness reimbursement programs.
• Employee discount and rewards program on various services.
• Opportunities for professional development and career advancement.