• Claims Examiner. Workers' Comp

    Amergis (Columbia, MD)


    Amergis, formerly known asMaxim Healthcare Staffing, has served our clients and communities by connectingpeople to the work that matters since 1988. We provide meaningful opportunitiesto our extensive network of healthcare and school-based professionals, ready towork in any hospital, government facility, or school. Through partnership andinnovation, Amergis creates unmatched staffing experiences to deliver the bestworkforce solutions.

     

    The Claims Examiner Workers’ Comp understands and participates in every aspect of the WC claim process. Working in a team approach, the Claims Examiner WC will make decisions concerning reserve adjustments, develop a plan of action, and determine claim resolution. The Claims Examiner WC also works with the Adjusters, WC Manager, and fellow Amergis team members.

    Essential Duties and Responsibilities:

    + Manages full cycle claim management for assigned states to resolution

    + Participates in conference calls with local offices, third-party administrators (TPAs), medical providers, and other Amergis employees in order to communicate status plans

    + Ensures legal deadlines are met

    + Monitors TPA’s file resolution plans

    + Represents Amergis in depositions, mediation, and conference calls regarding assigned claim files

    + Provides analysis on the financial aspects of assigned claims files

    + Provides excellent customer service to injured workers

    + Prepares WC claim reports for department management team

    + Reviews, identifies and makes recommendations for maintaining control and/or reducing the claims experience (loss history) of the company

    + Authorizes or revise reserve requests

    + Coordinates with Benefits team during employee’s absence

    + Coordinates with state programs and internal departments for transitional duty

    + Educates branch offices about all aspects of Workers’ Compensation

    + Assists Manager in achieving overall department goals

    + Performs other duties as assigned/necessary

    Minimum Requirements:

    + College degree preferred; or equivalent work experience

    + 5 to 10 years of Workers’ Compensation experience preferred

    + Some legal experience strongly preferred

    + Good organizational skills and attention to detail

    + Ability to work independently and cooperatively in a team environment

    + Ability to communicate effectively and provide excellent customer service with individuals at all levels of the organization

    + Computer proficiency, including Microsoft Office applications, required

    + Prior experience performing internet research

    + Ability to effectively elicit/provide information to and from appropriate individuals (including, but not limited to, supervisors, co-workers, clients) via strong communication skills; proficiency in the English language is required

    At Amergis Healthcare Staffing, wefirmly believe that our employees are the heartbeat of our organization and weare happy to offer the following benefits:

    Medical/Prescription,Dental, Vision, Health Advocacy (company paid if enrolled Medical), HealthAdvocate Employee Assistance Program, Health Savings Account , 401(k), 401(k)Company Match, Profit Sharing, Short Term Disability, Long Term Disability,Primary Caregiver Leave, Parental Leave, Life and Basic Accidental Death andDismemberment Insurance, Voluntary Life and Accidental Death and DismembermentInsurance, Hospital Expense Protection Plan, Critical Illness Insurance,Accident Insurance, Dependent Care Flexible Spending Account, Home and AutoInsurance, Pet Insurance, MilkStork, Transportation Benefit, EducationalAssistance Program, College Partnership Program, Paid Time Off/Company Holidays

     

    *Benefit eligibility is dependent onemployment status.

     

    AmergisHealthcare Staffing is an equal opportunity/affirmative action employer. Allqualified applicants will receive consideration for employment without regardto sex, gender identity, sexual orientation, race, color, religion, nationalorigin, disability, protected Veteran status, age, or any other characteristicprotected by law.

     

    This posting willremain active on job boards for 5 days from date of posting unless there is agood faith basis to extend the posting date.

     

    Please note thatthis pay range represents a good faith estimate of the compensation that willbe offered for this position based on the circumstances. The actual pay offeredto a successful candidate will take into account a wide range of factors,including but not limited to location, experience, and other variable factors.

     

    "Pursuant tothe San Francisco Fair Chance Initiative, Amergis will consider for employmentqualified applicants with arrest and conviction records"