Claims Specialist Dallas, TX
10000 75 expy 3rd floor Dallas, TX 75234
Schedule: M-F 8-5 with some flexibility
The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of Company.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:
- Receives claims, confirms policy coverage and acknowledgment of the claim
- Determines validity and compensability of the claim
- Establishes reserves and authorizes payments within reserving authority limits
- Manages non-complex and non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision
- Communicates claim status with the customer, claimant and client
- Adheres to client and carrier guidelines and participates in claims review as needed
- Assists other claims professionals with more complex or problematic claims as necessary
- Requires regular and consistent attendance
- Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (“ IIPP”).
- Additional projects and duties as assigned.
KNOWLEDGE & SKILLS:
- Excellent written and verbal communication skills.
- Ability to learn rapidly to develop knowledge and understanding of claims practice.
- Ability to identify, analyze and solve problems.
- Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets
- Strong interpersonal, time management and organizational skills.
- Ability to meet or exceed performance competencies
- Ability to work both independently and within a team environment.
- Bachelor' s degree or a combination of education and related experience.
- Minimum of 2 years of industry experience and claims management preferred