Description The Claims Manager will be responsible to act as a liaison for our clients in the management of Worker's Compensation claims. On behalf of the client, you will communicate (through phone and email as necessary) with doctors, insurance adjusters, Worker's Comp attorneys in order to use our process and strategies to get the best results for our clients on each claim. You will also provide strategy and status updates to clients following our process, in quarterly reports, and upon their request. The Claims Manager will also analyze patterns and trends in a client's claims history to ensure that our strategies are adjusted as necessary and continue to produce the highest level of results. This role would: • Educate Clients on Claims Management Procedures • Coordinate Claims Strategy with Clients, Adjusters, Attorneys, and Doctors • Analyze Claims & Financial data to provide summary and strategy to clients Responsibilities: • Provide exceptional customer service by delivering proactive, thoughtful, and professional communication to clients, ensuring their expectations for high-level service are consistently met. • Communicate effectively with all parties involved in insurance claims, including adjusters, attorneys, and medical professionals, to ensure accurate and timely updates while advocating for the best outcomes for clients. • Use strong negotiation and problem-solving skills to tactfully redirect claims processes when necessary, aligning them with the client’s best interests. • Analyze client claims data and overall claim histories to identify patterns, trends, and optimal strategies, leveraging basic mathematical and analytical skills to support decision-making. • Clearly explain claims strategies to clients, demonstrating an understanding of underlying concepts and calculations. • Utilize Salesforce and other tools to manage claims efficiently, access and analyze claims data, and generate reports as needed. • Perform day-to-day tasks using Microsoft Word, Excel, Outlook, Adobe, and other Microsoft Office applications, ensuring accuracy and efficiency in all computer-related activities. Qualifications: Customer Service skills. Our clients are used to a very high-level of service and we need the clients to receive proactive and thoughtful communication from our team.Strong communication skills. Sometimes the job is as simple as relaying information at the right time, following our process - or making a simple status request from an insurance adjuster so we're up to date on a claim. In some instances, the other parties involved in a claim (doctors, adjusters, attorneys, etc) may try to steer the claim in a direction that isn't the best for our client. You'll need to be able to tactfully direct the claim back into the best interest of the client. Training will be provided on when to do this, and tips can be provided on how, but strong communication/negotiation skills will be very useful.Basic Mathematical & Analytical skills. We review clients claims data to determine what strategy is best on each claim. We also review their overall claim history to determine patterns and trends and continue to deliver better results. Our system will do most of the math for you, but you'll need to understand the concepts behind the calculations in order to explain our strategy to clients.Basic Computer skills. We manage claims through Salesforce.You'll access a number of websites to gather claims data. You'll also use Microsoft Word, Adobe, PDFs,Outlook, and other Microsoft Office apps. Compensation: $50,000 - $60,000 yearly
• Provide exceptional customer service by delivering proactive, thoughtful, and professional communication to clients, ensuring their expectations for high-level service are consistently met. • Communicate effectively with all parties involved in insurance claims, including adjusters, attorneys, and medical professionals, to ensure accurate and timely updates while advocating for the best outcomes for clients. • Use strong negotiation and problem-solving skills to tactfully redirect claims processes when necessary, aligning them with the client’s best interests. • Analyze client claims data and overall claim histories to identify patterns, trends, and optimal strategies, leveraging basic mathematical and analytical skills to support decision-making. • Clearly explain claims strategies to clients, demonstrating an understanding of underlying concepts and calculations. • Utilize Salesforce and other tools to manage claims efficiently, access and analyze claims data, and generate reports as needed. • Perform day-to-day tasks using Microsoft Word, Excel, Outlook, Adobe, and other Microsoft Office applications, ensuring accuracy and efficiency in all computer-related activities.