Work From Home Sr. Account Claims Representative

June 19th, 2013

PMA is looking for a work from home Sr. Account Claims Representative s a member of our claims team, utilize your knowledge of Minnesota Workers Compensation to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropriate outcomes.

Responsibilities:

  • Promptly investigate all assigned claims with minimal supervision, including those of a more complex nature
  • Determine coverage, compensability, potential for subrogation recovery, and second injury fund (when applicable)
  • Alert Supervisor and Special Investigations Unit to potentially suspect claims
  • Ensure timely denial or payment of benefits in accordance with jurisdictional requirements
  • Establish appropriate reserves for self insured with documented rationale, maintain and adjust reserves over the life of the claim to reflect changes in exposure
  • Negotiate claims settlements with client approval
  • Establish and implement appropriate action plans for case resolution including medical and disability management, litigation management, negotiation and disposition
  • Work collaboratively with PMA nurse professionals to develop and execute return to work strategies

Qualifications:

  • Bachelor’s degree, or four or more years of equivalent work experience required in an insurance related industry required
  • At least 3-5 years experience handling lost time workers compensation claims required; past experience with Minnesota jurisdiction is required
  • Associate in Claims (AIC) Designation or similar professional designation desired.
  • Familiarity with medical terminology and/or Workers’ Compensation
  • Strong organizational skills with demonstrated ability to work independently and deal effectively with multiple tasks simultaneously
  • Proven critical thinking skills that demonstrate analysis/judgment and sound decision making with focus on attention to details
  • Strong verbal, written communication skills and customer service skills
  • Computer literacy, including working knowledge of MS Office Product Suite, i.e. WORD, Excel, PowerPoint.
  • Ability to travel for business purposes, approximately less than 10%

APPLY HERE: http://www.careerbuilder.com/JobSeeker/Jobs/JobDetails.aspx?Job_DID=J3J70L5WJNKFXJ6P8VM&siteid=cbindeed&ipath=EXIND


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