Skip to main content
Tallo logoTallo logo

Find Jobs

Find Jobs Near You – Available Work in Your Location

Skip to job details

Back to Results

Apply for this opportunity

To apply for this job, you'll continue to an external website or email application.

Optimal Inc.

Workers Compensation Plant Rep II

Career Insights for Claims Examiner (General)

See where this job fits in the broader career landscape. Knowing your career path helps you see what's possible from here.

Scorecard

Based on Missouri data

Review key factors to help you decide if this role fits your goals. How is this calculated?

Were these scores useful?

What they do

A Claims Examiner evaluates insurance claims in accordance with applicable contracts and government regulations within their insurance type. Determines member eligibility and financial responsibility of the insurance company.

$80,091 / year median in Missouri

+4% projected growth

Explore Career

Job Description

Workers Compensation Plant Rep II Optimal Inc. - 3.0 Claycomo, MO Job Details Contract 20 hours ago Qualifications Workers' compensation insurance knowledge High school diploma or
GED Full Job Description Position Description:
Primary Workers' Compensation Claims Handler at the Plant with a focus on excellent customer service, quality claims handling, and loss cost management. Plant-based position
Skills Required:
Workers' Compensation Experience Required:
3-5 years of Missouri Workers' Compensation Claims Adjusting experience
Education Required:
High School Diploma /
GED Education Preferred:
Bachelor's Degree Additional Information :
Analyze and process complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim Ability to handle a full case load, with proven ability to handle cases of increased severity. Workers' Compensation Lost Time claim handling experience Manage claims through well-developed action plans to ensure timely and cost-effective resolutions. Calculate and assign timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim. Calculate and pay benefits due; approve and make timely claim payments and adjustments; and settle clams within designated authority level. Prepare necessary state fillings within statutory limits. Coordinate vendor referrals for additional investigation and/or litigation management. Use appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims. Manage claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. Report claims to the excess carrier. Communicate claim activity and processing with the claimant and the client. Ensure claim files are properly documented, and claims coding is correct. Refer cases as appropriate to supervisor and management. Fully Onsite.

Benefits

  • Dental Insurance