Claims Operations Associate
On-siteHigh Point, North Carolina, United States
Job Summary
Manage low exposure workers' compensation claims by maintaining communication with employers, adjusters, and providers while discussing return-to-work status and payment appropriateness. Request medical notes, proper billing formats, and written or verbal information to determine the validity of medical-only claims and reserve accurately. Document all relevant written and oral communications in claim logs, enter medical notes as required, and index images. Assist in unit communication with customers and providers, identify potential subrogation claims, and notify supervisors. This entry-level role requires a BA/BS degree and 0-2 years of experience, with an adjuster license strongly desired.
Required Qualifications
- BA/BS Degree
- 0-2 years of workers compensation claims experience
- Knowledge of appropriate insurance principles and laws of workers' compensation, preferably jurisdiction specific
- Strong verbal and written communication
- Strong interpersonal, time management and organizational skills
- Strong negotiation skills
- Proven critical thinking skills that demonstrates analysis/judgment and sound decision making with focus on attention to detail
- Ability to perform with a sense of urgency
- Ability to work both independently and within a team environment
- Ability to travel for business purposes, approximately less than 10%
Desired Qualifications
- Adjuster license strongly desired or ability to obtain license within six months
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