Claims Examiner, Sr. jobs in High Point, NC

Company Details

With over 35 years of proven expertise in the workers' compensation industry, Key Risk delivers innovative and responsive solutions that provide our clients the freedom to do what they do best. Offering guaranteed cost options to employers nationwide, Key Risk focuses on delivering products and services within specialized verticals to reduce workers' compensation exposures and deliver industry-leading results.

All products and services are distributed through appointed insurance agents and brokers. Key Risk is a member company of W. R. Berkley Corporation, whose insurance company subsidiaries are rated A (Superior), Financial Size Category XV by A.M. Best Company and A (Strong), by S&P.

For further information about Key Risk please visit www.KeyRisk.com.

Responsibilities

Key Risk is looking for an enthusiastic Claims Associate professional who will be responsible for the management of low exposure workers’ compensation claims.  The Claims Associate will be responsible for learning workers compensation laws and providing outstanding service to our clients. This is an entry-level position with no experience necessary

Key functions include:

• Maintain good lines of communication with employers, adjusters, and providers
• Conduct investigation of workers' compensation claims assigned
• Request medical notes, proper billing format, and other written/verbal information from employers and medical providers to determine appropriateness of payment of medical bills and whether a claim is truly medical only
• Discuss with an employee, issues relative to whether a bill has been paid or whether travel or medical reimbursement has been issued
• Timely and accurately reserve for claims assigned
• Document medical notes and relevant written and oral communication received relative to claims in the log notes
• Discuss with an employer, issues relative to an injured workers’ return to work status
• Index images as needed
• Identify potential subrogation claims and notify appropriate supervisor
• Actively work with mentor and supervisor to develop skills to handle all technical aspects of claims, including coverage, disability benefit management, medical management, litigation management, file management, subrogation, reserving and settlement
• Maintain and demonstrate knowledge of the Workers' Compensation Act and Rules and Regulations in jurisdictions assigned
• Immediately notify management of large exposures

This position requires the individual to commute to our High Point NC office location.  

Qualifications

• BA/BS Degree
• Demonstrate exceptional oral and written communication skills
• Demonstrate functional understanding of basic medical terminology
• Superior organizational skills and attention to detail
• Evidence of self-motivation and requires general supervision
• Possess creative problem-solving skills
• Ability to manage multiple priorities and coordinate tasks
• Obtain license in jurisdiction as needed
• Commitment to increasing knowledge of workers compensation

Additional Company Details

Sponsorship Details