Claims Specialist-WC

Crawford Australia
Any Location, WA
Category Insurance
Remote
Job Description
Administers and resolves non-complex short term claims of low monetary amounts, including medical only claims. Documents and monitors open case inventory and ensures proper and timely closing of files.

Requirements

  • Conducts investigations of claims to confirm coverage and to determine liability, compensability, and damages.
  • Verifies policy coverage for submitted claims and notifies the insured of any issues.
  • Documents receipt and contents of medical reports.
  • Evaluates medical claims for potential fraud issues, loss control and recovery in accordance with insurance policy contracts, medical bill coding rules and state regulations.
  • Completes all reporting forms and file documentation.
  • Adheres to client and carrier guidelines and prepares written updates for supervisor to review.

Benefits

  • Pay and incentive plans that recognize performance excellence
  • Benefit programs that empower financial, physical, and mental wellness
  • Training programs that promote continuous learning and career progression while enhancing job performance
  • Sustainability programs that give back to the communities in which we live and work
]]>