Claim Representative I

EMERGENT HOLDINGS, INC. • Minneapolis, MN • 59min ago

Job Duties SUMMARY:

This is the entry level professional claim handler. Handles medical only and indemnity benefits. Exercises some discretion in the determination of compensability of claims. Considers many factors in the determination claim reserves. Negotiates and settles claims within given authority.

RESPONSIBILITIES/TASKS:

Verifies workers' compensation coverage of employers and injured employees.

Determines compensability under workers' compensation by thorough investigation of the claim.

Determines causal relationship between the reported injury and the incident to ensure appropriate payment of benefits.

Facilitates return to work for the injured employee.

Establishes timely and appropriate reserves based on the profile of the claim within given authority based on anticipated financial exposure.

Documents specifics of claims with potential for subrogation recovery, including amount of potential recovery monies.

Manages medical bills for non-indemnity and indemnity claims directly associated with the claimed injury. Approves payment based on knowledge of the treatment plan and medical support showing relationship of treatment to the injury.

Concludes and closes files following resolution of claims to meet internal performance standards while complying with state legislation to avoid penalties and manage expenses.

Negotiates settlements with attorneys or injured parties within given authority at the earliest possible point to bring cases to final disposition.

Works closely with manager on complex files or files above settlement/reserve authority.

Manages outside vendors to ensure cost containment efforts.

Establishes and maintains effective working relationships with all internal and external customers.

Stays abreast of changes in workers' compensation statutes, case law and rehabilitation efforts/advancements in order to accurately interpret and apply relevant laws.

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

EMPLOYMENT QUALIFICATIONS

Bachelor's degree in a related field. Relevant combination of education and experience may be considered in lieu of degree. Continuous learning, as defined by the Company's learning philosophy, is required. Certification or progress toward certification is highly preferred and encouraged.

Minimum one-year relevant experience that provides the necessary skills, knowledge and abilities or completion of claims trainee program. Bilingual skills preferred.

SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:

Ability and proficiency in the use of computers and company standard software specific to position.

Knowledge of medical and legal terminology related to the work.

Knowledge of workers' compensation laws and regulations, including jurisdictional laws.

Effective oral and written communication skills.

Effective customer service skills.

Ability to negotiate, build consensus and resolve conflict.

Ability to manage multiple priorities and meet established deadlines.

Attention to detail and analytical skills.

Ability to work independently as well as within a team.

WORKING CONDITIONS:

Work is performed in an office setting with no unusual hazards. Minimal travel required.

PAY RANGE:

Actual compensation decision relies on the consideration of internal equity, candidate's skills and professional experience, geographic location, market, and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $48,200 - $80,750.

We are an Equal Opportunity Employer. We will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an \"at will\" basis. Nothing herein is intended to create a contract.

LI-CD1

AFG

The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description.

We are an Equal Opportunity Employer. Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an \"at will\" basis. Nothing herein is intended to create a contract.

Apply here: https://www.aplitrak.com/?adid=YmJnZW5lcmljLjg5NDAyLjEzNzk4QGFmZ3JvdXBjb21wLmFwbGl0cmFrLmNvbQ

Minimum Education Required Not Specified

Minimum Experience Required Not Specified

Shift First (Day)

Number of Openings 1

Compensation $48,200.00 - $80,750.00 / Annually

Postal Code 55415

Job Type Full Time

Place of Work

On-site

Requisition ID

66234

Job Benefits

See job description

Similar Jobs

Administrative Specialist

Federal Reserve Bank • Minneapolis, MN • 1h ago

Management & Administrative

Minneapolis, MN Full time R-0000033328 Company Federal Reserve Bank of Minneapolis Are you looking to join a mission-oriented organization where you can build a career beginning with your administrative skillset while be...

1h ago

Go to Apply

Senior Counsel, Transactions & Market Compliance

Ford Motor Company • Saint Paul, MN • 1h ago

Legal & Paralegal

The Senior Counsel, Transactions and Market Compliance will serve as a senior legal expert, strategic advisor, and trusted partner to Ford Corporate Development, Supply Chain, Product Development, Finance, and other depa...

1h ago

Go to Apply

AI/Machine Learning Engineer

3M • Maplewood, MN • 1h ago

IT & Engineering

On-site US, Minnesota, Maplewood Full time R01170506 Job Description: AI/Machine Learning Engineer Collaborate with Innovative 3Mers Around the World Choosing where to start and grow your career has a major impact on you...

1h ago

Go to Apply

Aisles Online Service Lead

Hy-Vee Food Stores • New Hope, MN • 1h ago

Management & Administrative

New Hope, 42nd Ave N, New Hope, MN Part time R250170 Additional Considerations (if any): - At Hy-Vee our people are our strength. We promise "a helpful smile in every aisle" and those smiles can only come from a workforc...

1h ago

Go to Apply

Warehouse Part Time Days

Lowe's • Blaine, MN • 1h ago

Manufacturing & Warehouse

Your Impact at Lowe's As a Receiver/Stocker, you help keep the store clean, safe, and ready for customers by accurately receiving freight, stocking shelves, and organizing merchandise and top stock. You'll unload deliver...

1h ago

Go to Apply

Lead Counsel, Transactions & Market Compliance

Ford Motor Company • Saint Paul, MN • 1h ago

Legal & Paralegal

Ford Motor Company is seeking a transaction-focused attorney to join the Office of the General Counsel as Lead Counsel, Transactions and Market Compliance. In this role, you will provide practical, business-oriented lega...

1h ago

Go to Apply

Strategy & Execution Consultant - Principal

Huntington National Bank • Minnetonka, MN • 1h ago

Management & Administrative

Description Summary:The Principal Architect-Senior provides the technical vision and direction for the integration of all information systems. Duties and Responsibilities: Oversees the definition of architecture requirem...

1h ago

Go to Apply

Oracle Database Engineer

Huntington National Bank • Minnetonka, MN • 1h ago

IT & Engineering

Description This position is an onsite position and available to be filled at any Huntington Corporate office location (see location options on posting). Summary:The Oracle Database Engineer troubleshoots problems that i...

1h ago

Go to Apply

Senior Business Systems Analyst - IAM

Huntington National Bank • Minnetonka, MN • 1h ago

IT & Engineering

Description This position is an onsite position and available to be filled at any Huntington Corporate office location (see location options on posting) Summary: This Senior Business Systems Analyst IAM will be aligned t...

1h ago

Go to Apply

JANITORIAL CLEANER (H)

ABM Industries • Minneapolis, MN • 2h ago

Manufacturing & Warehouse

Overview We are looking for a reliable and experienced Janitorial Cleaner to perform a variety of cleaning duties to ensure a clean, safe, and orderly environment across assigned facilities. This role plays a critical pa...

2h ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)