WC Medical Claims Specialists

WC Medical Claims Specialists will make initial and subsequent claim determinations, issue orders as appropriate, and process and maintain claim information. They will also respond to requests from injured workers, employers, providers, and legislators, and document claim transactions and activities in the claim management system.

What You Will Do

The successful candidate will be responsible for reviewing and gathering information necessary to identify claim severity, sending Due Process notifications, and referring claims for medical reviews if necessary. They will also create cases for referrals to the Industrial Commission of Ohio and update and maintain tasks lists.

Why It Might Be a Fit

This role requires strong communication and organizational skills, as well as the ability to multitask and work effectively in a team. The successful candidate will be able to define problems, collect data, establish facts, and draw valid conclusions, and will be able to communicate effectively and professionally with injured workers, employers, providers, and the public.

Requirements

• 3 courses or 9 mos. trg. or 9 mos. exp. in English composition or grammar
• 3 courses or 9 mos. trg. or 9 mos. exp. in accounting, bookkeeping or general business mathematics
• 3 courses or 9 mos. trg. or 9 mos. exp. in communication or public speaking
• 9 mos. exp. involving contact with injured workers, employers, legislators, providers or their representatives & public
• Successful completion of one typing course or demonstrate ability to type 35 words per minute
• Or 12 mos. exp. as Workers' Compensation Claims Assistant, 16720
• Or 12 mos. exp. as BWC Customer Service Representative, 64451
• Or equivalent of Minimum Class Qualifications For Employment noted above

Benefits

• Medical Coverage
• Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period
• Paid time off, including vacation, personal, sick leave and 11 paid holidays per year
• Childbirth, Adoption, and Foster Care leave
• Education and Development Opportunities
• Public Retirement Systems (such as OPERS, STRS, SERS, and HPRS) & Optional Deferred Compensation (Ohio Deferred Compensation)