What are the responsibilities and job description for the Claims Specialist-A119 position at Vensure?
About Us
Founded in 2004, Vensure Employer Services provides PEO solutions and human resource outsourcing to small and mid-market businesses across the country. Through its subsidiaries, including VensureHR, the company processes more than $9 billion in payroll and supporting more than 300,000 worksite employees. With services including payroll, medical and voluntary benefits, workers' compensation, risk management, and HR administration, Vensure companies support a broad spectrum of industries, allowing small business owners to cost-effectively manage HR functions and turn their attention to growth and profitability initiatives
We offer a comprehensive benefits package including medical, dental, vision, 401k w/match, PTO, paid holidays, and more!
Position Summary
The Workers' Compensation Claims Specialist II serves as a liaison between the Company's clients and the respective insurance carrier responsible for adjudicating the clients' workers' compensation losses. This role requires that the coordinator monitor their assigned employers' workers' compensation claims, from inception through closure, to ensure that all salient aspects of claim adjudication are being effectively and efficiently performed.
Position Responsibilities
- Serve as a liaison between the Company's clients and the respective insurance carrier responsible for adjudicating the clients' workers' compensation losses
- Monitor worker's compensation claims, from inception through closure, including recognizing and pursuing alternative light duty assignments whenever possible, monitoring for accurate compensability, indemnity payment, claim closure, and subrogation decisions, ensuring accurate reserving practices, and monitoring both medical and legal management
- Work with the WC Claims Operations Manager to recognize opportunities to utilize the Company's alternative light duty (ALD) program, where all injured workers placed on modified duty are assigned to work at non-profit entities and paid by our clients in order to eliminate the entitlement to temporary partial disability benefits.
- Respond to and resolving numerous telephonic and e-mail inquiries from our clients and agents concerning various claim issues
- Prepare detailed claim summaries for presentation and discussion with our clients during quarterly claim reviews
- Assist intake with the reporting of new claims to the appropriate carrier
- Document the electronic claim file with various forms of correspondence and summations of telephonic conversations and significant action(s) taken
- Other Duties as assigned
Desired Knowledge, Skills and Abilities
- Proficient with the internet and Microsoft Office products
- Knowledge of workers' compensation procedures (in multiple jurisdictions) or possess the ability to learn
- This position requires strong communication skills (both written and oral)
- Strong organizational, analytical, and problem solving skills
- The ability to coordinate multiple projects, with varying and changing priorities, and to meet tight deadlines
- Must be able to work both independently and collaboratively and possess strong customer-service skills
Minimum Qualifications
- Six to twelve months of clerical or customer service experience preferred
- Bilingual (Spanish) a plus, but not required
Job Type: Full-time
Work Location: One location