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Workers Compensation Claims Specialist

Workers Compensation Claims Specialist
Atlanta, GA, United States
Job ID : R0009076
Job ID : R0009076

City: Atlanta

State: GA

Zip: 30339

Position Overview

This position is responsible for the being the liaison between the Aveanna Field Staff and the third party administrator. This role will require investigation of claims and insurance that our third party administrator is managing the claims in an effect manner. This position will resolve claims according to Best Practices and within authority limits by following established protocols to ensure that claims are handled in the most efficient, effective way while delivering excellent customer claims service.

Essential Job Functions

  • Investigating, reviewing, evaluating, and administering workers' compensation claims
  • Reviewing medical reports
  • Setting reserves
  • Filing documentation
  • Reviewing and approving medical bills for payment
  • Reviewing accident and injury reports
  • Interviewing and correspond with claimants, witnesses, attorneys, and physicians
  • Approving claims or recommending denial
  • Representing Aveanna at various workers' compensation and industrial leave claims actions and hearings
  • Perform other duties as assigned

Requirements

  • High School Diploma and 5 years or more experience in Claims and Litigation OR a Bachelor’s Degree and 4 years’ experience in Claims and Litigation
  • Knowledge of claims handling and legal statutes and procedures
  • Customer service experience
  • Workers Comp experience in California, Texas, and Pennsylvania and non-subscriber claim experience highly preferred

Other Skills/Abilities

  • Attention to detail
  • Time Management
  • Effective problem-solving and conflict resolution
  • Good organization and communication skills

#Aveanna

Requisition ID: R0009076

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