Claims Assistant - Workers Compensation

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Claims Assistant - Workers Compensation

TheZenith

icon Orlando, FL, US, 32817

iconFull Time

icon21 July 2024

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Can participate in WFH program but will need to be in the office based on office program guidelines

Under general supervision, performs diverse and complex clerical duties requiring thorough knowledge and understanding of all applicable procedures and policies.  Tasks require judgment and initiative.

The essential functions of this position include, but are not limited to, the following:

  • Responsible for assisting examiners and management of assigned caseload by performing clerical functions according to the Zenith timeframes and guidelines.
  • Performs detailed telephone investigations and maintains disability status checks with physicians and policyholders as directed by examiner.
  • Arranges medical examinations; may send physician cover letter with assistance or approval of examiner, and compose routine narrative memorandums and letters as directed by examiner.
  • Prepares and types legal documents; Answers, Declaration of Readiness to Proceed, Compromise and Release, and other related forms and memorandums.
  • Makes disability and medical payments within given authority. 
  • Inputs and monitors automatic disability schedule payments and cancellations.
  • Timely management of assigned tasks by systems diary.
  • Proficient use of computer to include claims information, coverage, DWC notices and payment verification. 
  • Word, Outlook Calendar, E-Mail  knowledge required.
  • Calculate wage statements and make appropriate adjustments in the system.
  • Understands and complies with medical management protocols and standards.
  • May assume back-up in absence of examiner.
  • Assists in training of claims assistants and other clerical personnel.
  • Works productively and harmoniously with others on a consistence basis.
  • Respond positively to direction and criticism of performance.
  • Consistently maintain professional and appropriate demeanor.
  • Perform other duties as assigned. 

Education, Skills and Experience Requirements  

  • High School Diploma or equivalent required.
  • Prior Workers’ Compensation claims assistant experience preferred.
  • Basic technical workers’ compensation claims knowledge preferred.
  • Strong verbal and written communication skills with emphasis on telephone communication required.
  • Strong math and reading skills required.
  • Meets all state regulatory standards regarding licensing, continuing education, and other requirements.
  • Bilingual skills preferred.
  • Strong skills in time management, organization, and problem solving required. 

*Qualifications may warrant placement in a different job level*

The expected salary range for this position is $37,787.55to $47,234.44. Actual pay will be adjusted based on experience, geographic location, and other job-related factors as permitted by law.  
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