Workers Compensation Claims Examiner II (Remote)

Job description

Job DetailsLevel: ExperiencedJob Location: Milwaukee - Waukesha, WI 53186Position Type: Full TimeEducation Level: High School Diploma or GEDSalary Range: $50,000.00 - $70,000.00 Salary/yearTravel Percentage: NegligibleJob Shift: DayJob Category: InsurancePOSITION SUMMARY: Under general supervision, manages all aspects of indemnity claims handling from inception to conclusion within established authority and guidelines. This position requires considerable interaction with clients, claimants on the phone, and with management, other Claims Examiners, and other TRISTAR staff in the office; therefore, consistently being at work on time is inherently required of this position. DUTIES AND RESPONSIBILITIES: Effectively manages a caseload of 150 or fewer workers’ compensation files, including reasonably complex claims. Initiates and investigates promptly* Determines compensability of claims and administers benefits based upon state law and following established Company guidelines* Manages medical treatment and medical billing, authorizing as appropriate* Communicates with claimants, providers, and vendors regarding claims issues. Computes and sets reserves within Company guidelines. Maintai...