Workers Claims Assistant I
at
Intercare Holdings Insurance Services
Fresno, California, United States
-
Full Time
Start Date
Immediate
Expiry Date
06 Jan, 26
Salary
0.0
Posted On
08 Oct, 25
Experience
0 year(s) or above
Remote Job
Yes
Telecommute
Yes
Sponsor Visa
No
Skills
Problem Solving, Customer Service, Team Work
Industry
Insurance
Description
Description
Summary:
Reports directly to the unit Claims Supervisor but takes primary direction for the assigned Claims Specialist(s). Responsible for providing clerical operations support to assigned Claims Specialist(s).
Essential Duties and Responsibilities:
Prepares new claims files
Calculates TTD, Wage Loss, VRMA and PD benefits
Issues compensation payments on diary schedule
Issues Benefit Notices
Doctor status calls and Employee/Employer contact calls
Employer contact calls to confirm light duty/modifies work
Works closely with Claims Specialist to complete clerical assignments
Prepares litigation documents such as C&R, Stipulations, Answers, etc
Prepares rehabilitation forms for filing with the rehabilitation unit
Handle calls from providers inquiring about unpaid bills and bill related questions
Review Mail and process direct pays bills such as Mileage Reimbursement
File and Serve duties (as needed)
Notepad documentation in Portal
Requirements
Competency:
To perform the job successfully, an individual should demonstrate the following competencies:
Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations.
Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
Team Work - Supports everyone's efforts to succeed.
Qualification Requirements:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and/or Experience:
High school diploma or general education degree (GED); or 1-2 years related experience and/or training; or equivalent combination of education and experience.
We’re an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.
Pursuant to the Los Angeles and San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest or conviction records.
Responsibilities
The Workers Claims Assistant I provides clerical operations support to assigned Claims Specialist(s) and prepares new claims files. They also handle various administrative tasks related to claims processing and communication with employers and providers.