Medical Claims Review Manager jobs in Aiken, SC

NWIA EEOICPA Claim Specialist

Nuclear Workers Institute of America (NWIA) is a group of experienced Advocates, Authorized Representatives and medical professionals representing former and current workers in filing claims under the Energy Employees Occupational Illness Compensation Program Act (EEOICPA). The Claim Specialist should have an upbeat attitude and be a helpful and positive presence in the workplace. They will support and maintain a positive work relationship through a personal commitment to the Company’s vision and values while demonstrating and maintaining strong communications skills.

 A Claim Specialist for NWIA will be responsible for ensuring that written documentation satisfies the criteria necessary to pursue a claim with The Department of Energy under The Energy Employees Occupational Illness Compensation Program Act (EEOICPA). The Claim Specialist oversees the claim process and serves as a liaison between company departments and NWIA. They will maintain communication with other company employees to ensure timely claim submissions. The Claim Specialist reports directly to the NWIA Director.

Essential Functions: 

·      Display proficient knowledge of the EEOICPA and related programs. Become familiar with program policies and procedures and keep abreast of all regulatory changes. 

·      Identify viable claims by reviewing client documents and medical records.  

·      Assist with medical record review, basic research, and data collection. 

• Provide researched, well-written documentation in support of our clients' claims.

·      Provide accurate, timely, up-to-date documentation/notes. 

·      Adhere to HIPAA policies & guidelines for the physical security of medical records and protected health information.

·      Participate in training and education as it relates to your position. Be knowledgeable of company policies and procedures.  

·      Effectively communicate with fellow employees and service providers. 

·      Work from home with self-discipline in respect to required hours of performance. 

·      Travel to the NWIA office as necessary for training and functions.

Education, Training, and Skill Recommendations/Requirements:

• Current RN, LPN license or equivalent medical knowledge/experience as deemed appropriate by the Company.
• Excellent writing, organizational, and time management skills.

·      Ability to work independently, multi-task and prioritize work.

• Must possess a professional, courteous, compassionate, and customer-oriented demeanor.
• Must be discreet, trustworthy, and possess a high level of integrity.

·      Excellent computer and internet skills.

·      Must possess a valid Driver’s License and proof of valid vehicle insurance.

·      COVID vaccination record or exemption.

Note:  This job description is not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with this position.

The Employer and Employee agree that the Employee's employment is subject to a trial period of 90 days commencing on the first day of employment.

I have read and understand my job description and I am willing and able to perform the responsibilities required for this position.

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NWIA EEOICPA Claim Specialist signature                                               Date

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Printed Name

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NWIA Director of Operations Signature