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2081 Claims Representative jobs in Philadelphia,PA

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Workers' Compensation Adjuster

BAYADA Home Health Care

Pennsauken, NJ 08110

$27-$29/hr

~ 20 min OnsiteHealth InsurancePaid Time OffRetirement Benefit

Minimum two (2) years of experience in Workers' Compensation claims handling
Basic proficiency in handling litigated Workers' Compensation claims
Ability to read, write and effectively communicate in English
Proficient in Microsoft computer products including Word, Excel, PowerPoint, and Outlook
Acceptable pre-employment assessment results
Learn various aspects of the organization through technology training, hands-on learning, cross-training, and site visits
Understand the company's policies as well as the applicable state Workers' Compensation laws that govern our work
Handle a caseload between seventy-five (75) and one hundred fifty (150) active Workers' Compensation claims while maintaining accurate and complete information on each assigned file
Proficiency in infectious disease claims and communicating and implementing the associated BAYADA policies
Obtain timely medical reports from claimant's treating physicians and promptly inform BAYADA office staff of the findings
Timely investigation of claims
Appropriate and accurate coding of claims
Timely completion of Action List items
Ability to accurately evaluate and present settlement evaluations/recommendations
Proactively works and collaborates with Third Party Administrator (TPA) and defense counsel to create effective strategies
Ongoing analysis of exposure and recommendations for mitigating the exposure and resolution of the claim is evidenced
Identification of and escalation of Third-Party Administrator service issues through to resolution
Continuously evaluate defense counsel and other strategic partnerships to ensure effectiveness and address issues as needed
Initiate and independently research claim information through compilation of statistics, analyzing data and summarizing findings for review
Participate in special projects: prepare reports and presentations using Microsoft Office (Word, PowerPoint etc.)
Five bases: Base Pay: $27-29 / hour plus bonus potential depends on qualifications