Claim Specialist II or III (Florida WC)
New
M
MEMICInsurance
RemoteFull-TimeMiddle
Salary not disclosed
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Job Details
- Experience
- Three years of workers’ compensation lost time and medical only claim handling experience preferred.
- Required Skills
- Microsoft ExcelNegotiation
Requirements
- Valid Florida Claims License (required).
- Three years of workers’ compensation lost time and medical only claim handling experience preferred.
- Bachelor’s degree preferred.
- Proficiency in computer systems including Word, Excel, and Image Right.
- Strong attention to detail and verbal/written communication skills.
- Ability to work effectively with organizational team members.
- Adaptable, flexible, and self-directed with effective time management skills.
- Valid driver’s license.
Responsibilities
- Communicate with insureds, injured workers, agents, brokers, witnesses, and attorneys to determine coverage, compensability, and liability.
- Administer the delivery of timely, accurate indemnity and medical benefits.
- Evaluate claim exposure and resolve claims, including managing litigated cases in collaboration with defense counsel.
- Maintain quality claim files in compliance with best practices and company procedures.
- Implement managed care strategies, coordinate rehabilitation, process bills, and monitor medical progress.
- Interact with State and Federal Boards and Commissions to establish and maintain reserves.
- Mentor and train less experienced Claims Department representatives.
- Maintain current knowledge of state laws and company procedures to educate insureds and injured workers.
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