Claims Assistant

Description:PRIMARY PURPOSE: To provide support to the claims staff and to perform other office tasks depending on the client program. ESSENTIAL FUNCTIONS and RESPONSIBILITIES Sets up and enters new claims into claims management system. Inputs and reviews notes/diaries in claims management system as instructed. Processes payments. Processes mail; handles filing, faxing and photocopying. Reviews, prepares, creates, and/or sends letters, reports, and forms. Answers and initiates telephone calls, sets up medical appointments, and may provide customer service as required. Other activities/projects as assigned including the preparation and distribution of computer reports. ADDITIONAL FUNCTIONS and RESPONSIBILITIES Performs other duties as assigned. Supports the organization's quality program(s). QUALIFICATIONS Education & LicensingHigh school diploma or GED required. ExperienceSix (6) months of clerical or customer service experience or equivalent combination of education and experience required. Skills & Knowledge Excellent oral and written communication PC literate, including Microsoft Office products Strong organizational skills Ability to work in a team environment Ability to meet or exceed Performance Competencies WORK ENVIRONMENT When applicable and appropriate, consideration will be given to reasonable accommodations. Mental: Clear and conceptual thinking ability; excellent judgment and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines Physical: Computer keyboarding, travel as required Auditory/Visual: Hearing, vision and talking
Requirements:The Candidate will need to be able to learn quickly and have experience working with computer and computer software. Prior claims system knowledge needed. Prior work with JURIS is a PLUS PLUS. Candidate needs to be able to work with clients, vendors, colleagues and injured workers in a professional kind manner. The candidate must have the ability to work in a fast past environment and ability to learn many task including making payments per adjuster/examiner instructions in Time Tracking. The candidate must have the ability to follow direction accurately and timely. The duties include but are not limited to being structed in the following: Issue Notice per Adjuster direction; Follow up with Doctor work status when requested; File & Serves to applicant attorneys and defense attorneys; Single Document File & Serve to DA; Completed Stipulations and/or Compromise and Release documents to injured worker; Subpoena Compliance; Reply to Notice of Representation; Notice of Improper SDT Service; File Treatment Dispute; Objection to PTP Request PQME; EDD Objection; Lien Objection; Mileage Objection; Request for records; Request for police report; Vendor/Provider Maintenance Form; SJDB Voucher post 1/1/2013; New PTP 9785 Reporting Requirements; PQME/AME Packages; Schedule QME Appointment; Stipulations & C&R to WCAB or prep for walkthrough; Defense Attorney Referral; Copy work tasks – MSA’s, Medicals to SSI, misc; Request for QME Panel; Request for Summary Rating and other task as instructed.