2 jobs found in glen allen

As a member of our Claims team, you will proactively manage medical only and limited lost time claims in order to minimize losses, manage permanent total claims in order to minimize losses, and provide superior customer service. Responsibilities: Contact accounts on First Notices of Loss to obtain missing information pertinent to file set-up Process payments, answer phone calls, authorize treatment associated with Medical Only claims Complete appropriate contacts within 24 hours of assignment, and establish and maintain appropriate diary for follow-up Determine whether treatment is appropriate and causally related to the compensable injury Redirect treatment to network physicians as appropriate Refer subrogation potential claims or potential permanency claims to Supervisor Work to ensure compliance with all appropriate jurisdictional requirements on Medical Only claims, including timely form filing if applicable Maintain a working knowledge of...

As a member of our claims team, utilize your knowledge of Workers Compensation to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropriate outcomes. In this position you will administer and resolve highest risk management expectations claims in a timely manner in accordance with legal statues, policy provisions, and company guidelines. Responsibilities: Promptly investigate all assigned claims with minimal supervision, including those of a more complex nature. Determine coverage, compensability, potential for subrogation recovery, and second injury fund (when applicable). Alert Supervisor and Special Investigations Unit to potentially suspect claims. Ensure timely denial or payment of benefits in accordance with jurisdictional requirements. Establish appropriate reserves with documented rationale, maintain and adjust reserves over the life of the claim to reflect changes in exposure. Negotiate...