Overview:
Prior Workers' Comp. claims assistant experience and advanced knowledge of CA WC laws, rules and regulations is critical; as well as, good handling of customer concerns relative to claims management. This position involves team work and the ability to work well with and without supervision. Must have excellent written and verbal communication skills, and provide non-technical support to one claims examiner and/or supervisor. This position also must provide leadership, claims assistant training to ensure compliance with Best Practices and share knowledge across the organization.
Responsibilities:
Responsibilities include, but are not limited to:
* Responsible for Pool/Team
* Ensure Timely payments of indemnity benefits
* Return phone calls in a timely fashion
* Ability to research payment type, dates of service and/or payment amounts
* Provide assistance and support regarding inquiries from policyholders, vendors and injured workers
* Provide assistance and guidance with the general support, medical support and pay diary tasks
* Provide back-up support for peers as needed;
* Train new claim assistants on new role and processes
* Conduct random audits of claims assistant work product on a monthly basis to ensure compliance with internal policies and procedures and CA State rules and regulations
* Assist with DIR / DWC CA State Audits and reinsurance audits
* Address personnel issues
Qualifications:
* Experience working (4 years or more) with and extensive knowledge of CA WC laws, rules and regulations
* Excellent written and verbal communication skills; ability to document notes and compose and edit correspondence and notices
* Excellent customer service skills; ability to handle most customer/vendor/injured worker issues; provide and assist through viable solutions
* Present an excellent image of company to external contacts
* Team player: able to work well with internal and external contacts
* Ability to work with numbers
* Work independently; ability to solve problems with little or limited supervision
* Excellent computer skills including word processing, spreadsheet development and analysis, electronic mail, database maintenance and update, develop graphic representation of data
* Excellent multi-tasking skills
The expected salary range for this role is $61,500.00/Yr. - $75,000/Yr.
Please note that the salary information shown above is a general guideline only. Salaries are based upon a wide range of factors considered in making the compensation decision, including, but not limited to, candidate skills, experience, education and training, the scope and responsibilities of the role, as well as market and business considerations.
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