Medical Only Claims Examiner/Administrative Support

Medical Only Claims Examiner/Administrative Support job with excellent group! Do you have workers comp claims experience? Do you enjoy and excel at Administrative support duties? Then, apply now for this exciting Medical Only Claims Examiner/Administrative Support job by clicking on the Apply Now button above! This is Job 2889.

Primary Objective of Position 

Above all, under the direction of the Claims Manager, the Medical Only Claims Examiner investigates and processes workers’ compensation claims involving medical care only. Also provides administrative support to the claims staff. 

Essential Functions of the Position

Essential duties listed below are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them if the work is similar, related or logical to the position.

  • Above all, investigate workers’ compensation claims.
  • Furthermore, determine compensability of claims per Iowa law.
  • Also, set reserve levels for expected losses and expenses for individual claims.
  • Evaluate claims for subrogation exposure.
  • Implement appropriate benefit for claimants.
  • Implement appropriate benefits for claimants.
  • Bring claims to resolution.
  • Resolve issues that arise on claims.
  • Conduct settlement negotiations with injured workers, either independently or with counsel.
  • Sort and scan mail, faxes and records.
  • Most noteworthy, provide excellent customer service to our members and injured workers.

Non-Essential Functions

  • Assist with Organization’s Annual Conference and Exhibit.
  • Serve on internal organizational committees as assigned.
  • Finally, perform other duties as assigned.

Examples of Performance Criteria

  • Above all, ability to communicate and understand workers’ compensation claims and medical terminology.
  • Furthermore, able to resolve issues in a timely fashion.
  • Also, ability to establish and maintain effective working relationships with staff, organization’s members, injured workers and service providers.
  • Able to handle daily routine work along with other assigned tasks and deadlines.
  • Ability to handle work interruption and resume tasks after interruption.
  • Reliability, organization, and attention to detail; Customer service skills.
  • Finally, ability to read and interpret claims information

Desired Qualifications

  • First, previous experience in workers’ compensation
  • Second, previous experience working with municipalities
  • Also, excellent verbal and written communication skills
  • Good computer skills.
  • Furthermore, good organization skills.
  • Most noteworthy, must be reliable.
  • Finally, a positive attitude.

Equipment/Job Location

  • Open office environment; Occasional travel required
  • Desktop computer and phone
  • Finally, multipurpose scanner and photocopier

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Additional resource links for West Des Moines, Iowa: City of Des Moines and Wikipedia.

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