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3008 Claims Representative jobs in Philadelphia,PA

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Remote Customer Service

Hire Standard Staffing

Philadelphia, PA

$120,000/yr

RemoteHealth Insurance

Comfortable using Zoom and other online communication tools.
No prior insurance experience is required — only a strong drive to succeed and a willingness to learn.
Must be a U.S. or Canadian citizen.

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Workers' Compensation Adjuster

BAYADA Home Health Care

Pennsauken, NJ 08110

$27-$29/hr

Paid Relocation to Pennsauken, NJ

RemoteHealth InsurancePaid Time OffRetirement Benefit

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
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
Able to handle multiple tasks
Ability to read, write and effectively communicate in English
Proven ability to progressively work in a more independent fashion with moderate direction
Schedule follow-up appointments for any claimant who misses a regularly scheduled medical visit
Proficiency in infectious disease claims and communicating and implementing the associated BAYADA policies
Continuously evaluate defense counsel and other strategic partnerships to ensure effectiveness and address issues as needed
Ensure that each work-related injury is reported within the state's filing deadline
Proactively works and collaborates with Third Party Administrator (TPA) and defense counsel to create effective strategies
Initiate and independently research claim information through compilation of statistics, analyzing data and summarizing findings for review
Demonstrated proficiency in effectively and timely communicating with service offices, injured employees, and Third-Party Administrator
Ability to arrange information and files in a useful manner
Demonstrated record of strong interpersonal skills
Identification of and escalation of Third-Party Administrator service issues through to resolution
Ability to accurately evaluate and present settlement evaluations/recommendations
Coordinate placement of injured workers in modified or light-duty placements as directed by their treating physician; seek alternate work assignments for claimants if job opportunities do not exist within the company; facilitate completion of the company's light-duty payroll on a weekly basis
Minimum two (2) years of experience in Workers' Compensation claims handling
Four (4) year college degree preferred
Proficient in Microsoft computer products including Word, Excel, PowerPoint, and Outlook
Participate in special projects: prepare reports and presentations using Microsoft Office (Word, PowerPoint etc.)
Ongoing analysis of exposure and recommendations for mitigating the exposure and resolution of the claim is evidenced
Basic proficiency in handling litigated Workers' Compensation claims
Timely completion of Action List items
Assist in the creation and management of policies, practices and procedures related to BAYADA's Employee Claims and Safety office
Continue to develop knowledge base of claims handling and jurisdictional knowledge through claims handling and independent research
Acceptable pre-employment assessment results
No greater than 5% of caseload will be valued at greater than BAYADA's current deductible
Ensure that each BAYADA office has a reliable Panel List of Providers and maintain regular contact with office directors to guarantee continued satisfaction with ECS's outside medical vendors
Proven record of goal achievement

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Patient Account Representative

Motion Recruitment

Camden, NJ 08101

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Workers Compensation Claims Adjuster - DE, PA, NJ

Gallagher Bassett

Mount Laurel, NJ 08054

RemoteFlexible ScheduleHealth InsurancePaid Time OffRetirement Benefit

Jurisdictional Experience: DE
Knowledge of accepted industry standards and practices.
Jurisdictions: DE
Location: This is role is open to remote work
Claims Background: Workers Compensation, Lost-Times
Active Adjusters' licenses : DE
Appropriately licensed and/or certified in all states in which claims are being handled.
Computer experience with related claims and business software.
High School Diploma.
Licenses: DE
Minimum of 3 years related claims experience.

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