JOB TITLE: Claims Assistant II
DEPARTMENT: Claims
REPORTS TO: Claims Manager/Supervisor
LOCATION: San Francisco

JOB SUMMARY:

Prior Workers Comp. claims assistant experience and basic knowledge of CA WC laws, rules and regulations is critical; as well as, good handling of customer concerns relative to claims management. This position involves team work and the ability to work well with and without supervision. Must have excellent written and verbal communication skills, and provide non-technical support to claims examiners and/or supervisor.

JOB DUTIES:

Responsibilities include, but are not limited to:
" Timely payment of indemnity payments;
" Ability to research payment type, dates of service and/or payment amounts;
" Conduct disability confirmation calls as assigned through Microsoft Outlook Tasks and document file accordingly;
" Provide day-to-day support to the Claims Examiners this position is assigned to;
" Provide assistance and support regarding inquiries from policyholders, vendors and injured workers;
" Set up new claims;
" Work on Claim Files, Medical Billing and In-house billing queues on a daily basis;
" Complete notices, including but not limited to, objections, denials and acceptance notices on a timely basis;
" Complete referrals including, but not limited to, legal, utilization review and investigators;
" Provide back-up support for peers as needed;
" Handle special projects as assigned

SKILLS:

" Experience working (2 years or more) with and basic knowledge of CA WC laws, rules and regulations
" Excellent written and verbal communication skills; ability to document notes and compose and edit correspondence and notices
" Excellent customer service skills; ability to handle most customer/vendor/injured worker issues; provide and assist through viable solutions
" Present an excellent image of company to external contacts
" Team player: able to work well with internal and external contacts
" Ability to work with numbers
" Ability to follow procedures as documents, raise questions when facts warrant
" Work independently; ability to solve problems with little or limited supervision
" Excellent computer skills including word processing, spreadsheet development and analysis, electronic mail, database maintenance and update, develop graphic representation of data
" Excellent multi-tasking skills