[Remote] Worker's Comp Claim Specialist

Note: The job is a remote job and is open to candidates in USA. Sheakley is a company focused on managing workers’ compensation claims. The Return-to-Work Specialist coordinates communication among various stakeholders to ensure timely claim processing and facilitate safe return-to-work outcomes.ResponsibilitiesDirectly reports to the Return-to-Work Specialist Team Leader and/or Claims SupervisorResponsible for entering initial claims when necessary, completing initial and subsequent contact to employer, provider, IW, and BWC as appropriate while accurately documenting the results of gathered informationResponsible for complete follow-up on claims, including transferring to Case Management when appropriate, or case closure as appropriateResponsible for gathering and documenting any information on (RTW) return to work, missing claims master fields, continued treatment, etcResponsible for facilitating return to work by communicating with the employer, TPA, provider, injured worker, attorneys and BWC as appropriateResponsible for gathering complete information on all mandatory field requirements to ensure transmission to the BWCResponsible for obtaining additional medical information and/or C9s to move claims towards RTW (return to work) or other forms of claim resolutionResponsible for completing follow-up on all subsequent documents for potential claim updates and communicating any claim updates to the appropriate partiesResponsible for proactively and aggressively pursuing a safe and timely (RTW) return to work outcome for all managed claims thereby positively impacting MOD. This includes regularly utilizing RTW tools such as vocational rehab, field case managers, modified duty task lists, etcResponsible for providing excellent customer service to both internal and external customersResponsible for assisting other Return to Work Specialists and Claim Review Specialists as needed. Will assist with claims assigned to the CM in terms of employer needs, but do not perform any tasks related to the clinical case management of the IWResponsible for re-opening claims when injury re-aggravation or additional medical treatment deems it appropriateRequired to meet team quality, productivity, and optimal RTW standardsRequired to maintain work queues- including processing documents within one business day and keeping claim memos currentRequired to respond to voicemails, emails and other messages in a timely manner (1 business day)Required to log into any applicable call centers on a daily basisRequired to prepare for and attend client meetings when applicableResponsible for maintaining and developing team work with all departments of UniCompDemonstrates and promotes Sheakley Core ValuesOther miscellaneous duties/projects as assigned by managementSkillsKnowledge and skills at a level normally acquired through the completion of a high school education or equivalentAttention to detail, flexibility, and ability to multi-taskAbility to maintain accuracy and production requirementsAbility to problem solveAbility to handle sensitive information and maintain a high level of confidentialityAbility to effectively prioritize tasksPrevious customer service experience preferred1 year of previous claim or workers' compensation related experience preferredTyping speed of 40+ WPMMedical terminology or equivalent experience preferredProficiency in Microsoft Office products including Word, Excel and OutlookAverage computer skills required, above average skills preferredCompany OverviewServing employers since 1963, Sheakley provides the perfect blend of practical and innovative Risk Management and Safety solutions that help businesses save time, decrease accidents, increase compliance, and reduce overall costs. It was founded in 1963, and is headquartered in Cincinnati, Ohio, USA, with a workforce of 201-500 employees. Its website is http://www.sheakley.com/.



Apply To This Job