Claims Specialist II - RI Temps : Job Details

Job Description

** DIRECT HIRE**

Investigation & CompensabilityConduct thorough investigations and determine compensability on claims with uncertain or questionable factorsLeverage additional investigative resources when needed

Resolution StrategyDesign and implement strategies for optimal claim resolutionWeigh options and consult your manager when necessary to determine the best course of actionDisability & Medical ManagementProactively return injured workers to safe, appropriate workEnsure medical treatment is appropriate and causally related to the accepted injuryUse your knowledge of medical terminology and procedures to engage resources when necessary

Settlement & LitigationEvaluate and negotiate moderate dispute claims to settlementHandle litigated claims with minor issues and consult on litigation strategy as neededCompliance & Financial ManagementFollow Claims Quality Guidelines, handling instructions, and all applicable regulationsMaintain required licenses in good standingAccurately reserve and issue timely payments, projecting benefits including scarring and loss of useConsider Medicare and other exposures early in the life of the claim

What You'll Bring:Bachelor's degree or 3–5 years of relevant workers' compensation claims experienceUnderstanding of WC law, claim procedures, and medical treatment guidelinesTech-savvy with proficiency in Microsoft Office SuiteStrong communication and decision-making skillsEmpathy, professionalism, and a customer-first mindset

Company Description

Your Complete Satisfaction is Our Number One GoalSince 1978, we have specialized in supplying temporary and direct hire staffing to Rhode Island corporations of all types - including banks, hospitals, manufacturing firms, colleges, professional and legal firms, and governmental agencies.

Your Complete Satisfaction is Our Number One Goal\r\nSince 1978, we have specialized in supplying temporary and direct hire staffing to Rhode Island corporations of all types - including banks, hospitals, manufacturing firms, colleges, professional and legal firms, and governmental agencies.