BCforward is currently seeking for a highly motivated Claims Adjuster - Workers Compensation - at Lake Mary, FL 32746.
Job Title: Claims Adjuster - Workers Compensation
Location: Lake Mary, FL 32746.
Duration: 2+ months
PRIMARY PURPOSE:
To analyze mid- and higher-level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
· Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
· Develops and manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments.
· Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
· Manages subrogation of claims and negotiates settlements. Communicates claim action with claimant and client.
· Ensures claim files are properly documented and claims coding is correct. May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review. Maintains professional client relationships.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
· Performs other duties as assigned. Supports the organization's quality program(s).
· Travels as required.
QUALIFICATIONS
· Education & Licensing Bachelor's degree from an accredited college or university preferred.
· Experience Four (4) years of claims management experience or equivalent combination of education and experience required.
SKILLS & KNOWLEDGE
· Working knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social Security and Medicare application procedure as applicable to line of business Excellent oral and written communication, including presentation skills PC literate, including Microsoft Office products Analytical and interpretive skills Strong organizational skill Good interpersonal skills Excellent negotiation skills Ability to work in a team environment Ability to meet or exceed Service Expectations
WORK ENVIRONMENT
· 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. The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
QUALIFICATIONS:
· This is a temporary assignment - - Must have 3-5 years WC claims handling experience multi client desk, Fast paced environment, must be quick study. multiple jurisdictions in multiple southeast states.AL, FL, GA, KY, LA, MS, NC, SC, TN. All Adjuster License, Lines License preferred, FL WC license acceptable.
EDUCATION:
· High School Graduate/GED
Company DescriptionBC Forward began as an IT business solutions and staffing firm. Founded in 1998, BCforward has grown with our customers’ needs into a full-service personnel solutions organization. Headquartered in Indianapolis, Indiana, BCforward also operates numerous delivery centers across North America and India. We are currently the largest consulting firm and largest MBE certified firm in Indiana. Our uninterrupted growth has allowed BCforward to deliver uniquely configured IT staffing and project solutions for over years of catering to our customers’ specific needs. BCforward currently maintains a team of over 5000 global resources. With our additional brand, Stafforward, together we have the capabilities to deliver services for a variety of industries in both public and private sectors which allows us to address your most challenging needs.www.BCforward.com