JobMesh

Workers' Comp Claim Representative II - CA/CO/AZ

Blue Cross Blue Shield of Michigan · US

SUMMARY: Claim Representative I: This is the entry level professional claim handler. Handles medical only and indemnity benefits. Exercises some discretion i...

Job description

SUMMARY: Claim Representative I: This is the entry level professional claim handler. Handles medical only and indemnity benefits. Exercises some discretion in the determination of compensability of claims. Considers many factors in the determination claim reserves. Negotiates and settles claims within given authority. Claim Representative II: This is the intermediate level of the claim handler career path. Handles moderate to difficult claims. Exercises progressively more discretion in the determination of compensability of claims. Considers many factors in the determination claim reserves. Negotiates and settles claims within given authority. Claim Representative III: This is the advanced level of the claim handler career path. Investigates claims and exercises significant discretion in the determination of compensability of claims. May handle large, more complex customers requiring high touch, labor intensive claim service. Considers many factors in the determination claim reserves. Negotiates and settles claims within given authority. Mentors lower level claim handlers. Coordinates special projects and provides guidance to others. RESPONSIBILITIES/TASKS: Claim Representative I,...