Job description
Athens Position Details
Position Title: Senior Claims Examiner
Department: Workers’ Compensation
Reports To: Claims Supervisor
FLSA Status: Non-Exempt
Job Grade: 12
ATHENS ADMINISTRATORS
Since our founding in 1976, Athens Administrators has been a recognized leader in third-party claims administration services. However, more important than what we do is how we do it. Athens employees provide service that translates into real and lasting benefits—every single day! With offices throughout the United States, Athens Administrators offers Workers’ Compensation, Property & Casualty, Managed Care and Program Business solutions. Athens is proud to be a third-generation family-owned company and is dedicated to its core values of honesty and integrity, a commitment to service and results, and a caring family culture. We are so proud that our employees have consistently voted Athens as a Best Place to Work!
POSITION SUMMARY
Athens Administrators has an immediate need for a Senior Claims Examiner to support our Workers Compensation department and can be located remotely in California if technical requirements are met. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday-Friday at 37.5 hours a week with the option of a flex schedule. The Senior Claims Examiner will adjust workers’ compensation claims from inception through settlement and closure, ensuring timely processing of claims and payment of benefits, managing and directing medical treatment, setting reserves, and negotiating settlements.
PRIMARY RESPONSIBILITIES
Our new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned:
Position Title: Senior Claims Examiner
Department: Workers’ Compensation
Reports To: Claims Supervisor
FLSA Status: Non-Exempt
Job Grade: 12
ATHENS ADMINISTRATORS
Since our founding in 1976, Athens Administrators has been a recognized leader in third-party claims administration services. However, more important than what we do is how we do it. Athens employees provide service that translates into real and lasting benefits—every single day! With offices throughout the United States, Athens Administrators offers Workers’ Compensation, Property & Casualty, Managed Care and Program Business solutions. Athens is proud to be a third-generation family-owned company and is dedicated to its core values of honesty and integrity, a commitment to service and results, and a caring family culture. We are so proud that our employees have consistently voted Athens as a Best Place to Work!
POSITION SUMMARY
Athens Administrators has an immediate need for a Senior Claims Examiner to support our Workers Compensation department and can be located remotely in California if technical requirements are met. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday-Friday at 37.5 hours a week with the option of a flex schedule. The Senior Claims Examiner will adjust workers’ compensation claims from inception through settlement and closure, ensuring timely processing of claims and payment of benefits, managing and directing medical treatment, setting reserves, and negotiating settlements.
PRIMARY RESPONSIBILITIES
Our new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned:
- Respond to inquiries from the employer, employee, doctors and attorneys
- Establish and maintain appropriate reserves
- Administer benefits and ensure appropriateness of all payments
- Discuss appropriateness of medical treatment with medical case manager
- Determine compensability
- Negotiate settlement of claim, liens, rehabilitation plans, etc
- Prepare and present reports to clients
- Document and code the claim files and claims system with all relevant information
- Maintain and update action plans within specified time frames
- Negotiate settlements
ESSENTIAL POSITION REQUIREMENTS
The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations.
- High School Diploma or equivalent (GED) required for all positions
- AA/AS or BA/BS preferred but not required
- Administrators Certificate from Self-Insurance Plans will be required within one year of employment if not already obtained
- Must possess a current Experienced Indemnity Claims Adjuster Designation, provided by an insurer, as defined in California Code of Regulations, Title 10, Chapter 5, Subchapter 3, Section 2592.01(f)
- 3+ years recent workers compensation claims handling experience required
- At least 5 years’ of workers compensation claims experience preferred
- Solid knowledge of workers compensation laws, policies and procedures
- Completion of IEA or equivalent courses
- Reasoning ability, including problem solving and analytical skills, i.e., proven ability to analyze facts, identify issues and make appropriate recommendations and solutions for resolution
- Proficiency in determining case value and negotiating settlements
- Understanding of medical and legal terminology
- Mathematical calculating skills
- Well-developed verbal and written communication skills with strong attention to detail
- Excellent organizational skills and ability to multi-task
- Ability to type quickly, accurately and for prolonged periods
- Proficient in Microsoft Office Suite
- Ability to learn additional computer programs
- Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization
- Valid Driver’s license and availability for local travel
APPLY WITH US
We look forward to learning about YOU! To be considered, please submit your resume and application directly through our website at http://www.athensadmin.com/careers/job-openings/ Feel free to include a cover letter if you’d like to share any other details. All applications received are reviewed by our in-house Corporate Recruiter.
This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training.
Athens Administrators is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development.
THANK YOU!
We look forward to reviewing your information. Applying for jobs isn’t necessarily fun, but we promise we are. Don’t forget to check out our website at www.athensadmin.com as well as our LinkedIn, Glassdoor, and Facebook pages!
Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Additionally, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. Further information about our comprehensive benefits package may be found on our website at
https://www.athensadmin.com/careers/why-work-here
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