Insurance Specialist - Workers' Compensation Claims
Total Rehab-Orthopedic & Sports Specialists Total Rehab-Orthopedic & Sports Specialists Grinnell, IA Grinnell, IA Contract Contract $25 - $35 an hour $25 - $35 an hour 3 hours ago 3 hours ago 3 hours ago Job Overview:
As an Insurance Specialist specializing in Workers' Compensation Claims, your primary responsibility will be to navigate and resolve complex workers' compensation claims efficiently and effectively.
You will work closely with clients, employers, medical professionals, and legal entities to ensure fair and timely resolution of claims.
Your expertise in interpreting policy language, understanding regulatory requirements, and assessing medical documentation will be crucial in facilitating accurate claim determinations.
The role requires a strong ability to communicate clearly, negotiate settlements, and maintain meticulous documentation throughout the claims process.
Key
Responsibilities:
Claims Assessment and Investigation:
Conduct thorough investigations into workers' compensation claims, gathering relevant information, and analyzing policy coverage.
Review medical records, accident reports, and witness statements to assess the validity and severity of claims.
Collaborate with medical professionals to evaluate the extent of injuries and treatment plans.
Policy Interpretation and Compliance:
Interpret insurance policies and ensure compliance with regulatory requirements and company guidelines.
Advise clients and stakeholders on coverage limits, exclusions, and other pertinent policy details.
Stay updated on changes in workers' compensation laws and regulations to ensure adherence to legal requirements.
Communication and Negotiation:
Communicate with claimants, employers, attorneys, and other relevant parties to gather information and negotiate settlements.
Provide clear and timely updates on claim status, decisions, and next steps to all stakeholders involved.
Mediate disputes between parties and facilitate resolution through negotiation or alternative dispute resolution methods.
Documentation and Record Keeping:
Maintain accurate and detailed records of all claim-related activities, including correspondence, reports, and settlement agreements.
Prepare comprehensive claim files for internal review, audits, and regulatory compliance purposes.
Ensure confidentiality and security of sensitive claim information in accordance with privacy laws and company policies.
Customer Service and Support:
Provide exceptional customer service to clients, demonstrating empathy, professionalism, and responsiveness in all interactions.
Address client inquiries, concerns, and complaints promptly and effectively, striving to achieve satisfactory outcomes.
Educate clients and stakeholders on workers' compensation processes, rights, and responsibilities to foster understanding and cooperation.
Qualifications:
Bachelor's degree in insurance, business administration, or a related field (preferred).
Previous experience in workers' compensation claims management or related insurance field.
Strong knowledge of workers' compensation laws, regulations, and industry best practices.
Excellent analytical, problem-solving, and decision-making skills.
Exceptional communication and interpersonal skills, with the ability to build rapport and negotiate effectively.
Proficiency in relevant software applications for claims processing and documentation.
Certification or licensure in insurance claims adjusting (preferred).
Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.
Working Conditions:
This is a contract work from home opportunity.
Working hours should be conducive to insurance companies and Total Rehab's office hours.
10-15 hours / week is anticipated.
3 month contract.
Please contact Stacey at email protected or 641-236-4506 if interested.
.
Estimated Salary: $20 to $28 per hour based on qualifications.
As an Insurance Specialist specializing in Workers' Compensation Claims, your primary responsibility will be to navigate and resolve complex workers' compensation claims efficiently and effectively.
You will work closely with clients, employers, medical professionals, and legal entities to ensure fair and timely resolution of claims.
Your expertise in interpreting policy language, understanding regulatory requirements, and assessing medical documentation will be crucial in facilitating accurate claim determinations.
The role requires a strong ability to communicate clearly, negotiate settlements, and maintain meticulous documentation throughout the claims process.
Key
Responsibilities:
Claims Assessment and Investigation:
Conduct thorough investigations into workers' compensation claims, gathering relevant information, and analyzing policy coverage.
Review medical records, accident reports, and witness statements to assess the validity and severity of claims.
Collaborate with medical professionals to evaluate the extent of injuries and treatment plans.
Policy Interpretation and Compliance:
Interpret insurance policies and ensure compliance with regulatory requirements and company guidelines.
Advise clients and stakeholders on coverage limits, exclusions, and other pertinent policy details.
Stay updated on changes in workers' compensation laws and regulations to ensure adherence to legal requirements.
Communication and Negotiation:
Communicate with claimants, employers, attorneys, and other relevant parties to gather information and negotiate settlements.
Provide clear and timely updates on claim status, decisions, and next steps to all stakeholders involved.
Mediate disputes between parties and facilitate resolution through negotiation or alternative dispute resolution methods.
Documentation and Record Keeping:
Maintain accurate and detailed records of all claim-related activities, including correspondence, reports, and settlement agreements.
Prepare comprehensive claim files for internal review, audits, and regulatory compliance purposes.
Ensure confidentiality and security of sensitive claim information in accordance with privacy laws and company policies.
Customer Service and Support:
Provide exceptional customer service to clients, demonstrating empathy, professionalism, and responsiveness in all interactions.
Address client inquiries, concerns, and complaints promptly and effectively, striving to achieve satisfactory outcomes.
Educate clients and stakeholders on workers' compensation processes, rights, and responsibilities to foster understanding and cooperation.
Qualifications:
Bachelor's degree in insurance, business administration, or a related field (preferred).
Previous experience in workers' compensation claims management or related insurance field.
Strong knowledge of workers' compensation laws, regulations, and industry best practices.
Excellent analytical, problem-solving, and decision-making skills.
Exceptional communication and interpersonal skills, with the ability to build rapport and negotiate effectively.
Proficiency in relevant software applications for claims processing and documentation.
Certification or licensure in insurance claims adjusting (preferred).
Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.
Working Conditions:
This is a contract work from home opportunity.
Working hours should be conducive to insurance companies and Total Rehab's office hours.
10-15 hours / week is anticipated.
3 month contract.
Please contact Stacey at email protected or 641-236-4506 if interested.
.
Estimated Salary: $20 to $28 per hour based on qualifications.
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