Claims Assistant II
Core
Administrative and operational support for the workers' compensation claims team, focusing on record maintenance, data processing, and compliance.
Role type
Claims Assistant II (Administrative Support)
Builds
Accurate claim records and statistical data for workers' compensation cases
Domain
Insurance / Workers' Compensation
Deliverable
dashboards & analysis
Required skills
Workers' compensation claims procedures, Microsoft Office Suite, data entry, document management, vendor coordination, lien review, medical authorization processing, regulatory compliance
Preferred skills
College degree, 1-2 years claims processing experience, career development interest in insurance
Technologies
ImageRight, Powersuite, Rising, CMS COB&R
Responsibilities
Organize digital claim records and remove duplicates; Complete claim maintenance checklists and process data corrections; Perform manual Medicare queries and document records; Process class code corrections; Manage claim file closures, re-opens, and reassignments; Assist with subpoenas and lien reviews; Coordinate vendor referrals and utilization review submissions; Maintain contact with WCAB for status updates; Review adjuster tasks for medical authorization requests; Provide administrative assistance to adjusters; Back up manual payment entry.
Seniority
Entry-level to Junior, hands-on IC
