Dallas, TX 75201
To analyze reported lower-level workers compensation claims to determine benefits due; and to ensure ongoing adjudication of claims within company standards and industry best practices.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES:
Adjusts medical-only claims and minor lost-time workers compensation claims under close supervision.Supports other claims representatives, examiners and leads with larger or more complex claims as necessary.Processes workers compensation claims determining compensability and benefits due; monitors reserve accuracy, and files necessary documentation with state agency.Communicates claim action/processing with claimant, client and appropriate medical contact.Ensures claim files are properly documented and claims coding is correct.May process routine payments and prescriptions and status reports for lifetime medical claims and/or defined period medical claims.Maintains professional client relationships.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES:
Performs other duties as assigned.Supports the organization's quality program(s).
When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding, travel as required
Auditory/Visual: Hearing, vision and talking
NOTE: Credit security clearance, confirmed via a background credit check, is required for this position.