Workers Compensation Claims Representative
Core
Investigate and adjust workers compensation claims, determine policy coverage and liability, and authorize medical payments to injured workers.
Role type
Workers Compensation Claims Representative
Builds
Claim resolutions and medical payment authorizations
Domain
Insurance / Workers Compensation
Deliverable
client delivery
Required skills
Medical terminology, policy analysis, legal liability assessment, data organization, independent decision-making, complex issue resolution
Preferred skills
Product knowledge development
Technologies
Insurance policies, endorsements, forms
Responsibilities
Investigate and assemble facts for claims, review medical bills and authorize payments, conduct on-site and remote investigations, contact stakeholders to secure information, attend arbitrations or mediations, service policyholders and injured workers
Seniority
Individual Contributor