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Maxim Healthcare Services Direct

Claims Examiner Workers Comp I

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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.

$83,133 / year median in Maryland

-1% projected decline

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Job Description

Claims Examiner Workers' Comp I Maxim Healthcare Services Direct
  • 3.5 Columbia, MD Job Details Full-time $20
  • $24 an hour 5 hours ago Benefits Profit sharing Commuter assistance Health savings account Caregiver leave AD&D insurance Paid holidays Disability insurance Health insurance Flexible spending account Tuition reimbursement Paid time off Parental leave Employee assistance program Vision insurance 401(k) matching Employee discount Life insurance Pet insurance Qualifications Insurance claim adjustments processing Customer communication Computer literacy Bachelor's degree in business Mid-level Legal experience 3 years Workers' compensation insurance knowledge Bachelor's degree Internal employee customer service Calendar management Insurance claims litigation Desktop applications Organizational skills Productivity software Human Resources Insurance claims status tracking Business Insurance claims reserve management Court depositions Full Job Description Claims Examiner Workers' Comp Location•Columbia, MD•
Hybrid Pay Range:
$20.00
  • $24.
00 + $4,000 annual bonus potential The Workers' Compensation (WC) Claims Examiner I participates in every aspect of the WC claim process. Working independently and in coordination with other WC team members, the WC Examiner I will consult with the WC Manager regarding reserve adjustments, a plan of action, and the appropriate settlement value of assigned claim files. The WC Claims Examiner I also works with the In-take Coordinators, other Claim Examiners in the department, the third party administrator, the WC Manager and fellow Maxim co-workers in the execution of company business.
Essential Duties and Responsibilities:
Brings pending and new WC claims including those that are litigated, to resolution. Participates in calls with local offices, third-party administrators (TPAs), medical providers, attorneys, and other Maxim team members, in order to agree upon, communicate, and execute claim handling plans. Monitors TPA files. Ensures legal deadlines are met. Maintains WC Department Legal Calendar. Participates in depositions, mediations, and calls regarding assigned claim files. Reviews and comments on the financial aspects of assigned claim files. Educates branch offices about workers compensation. Provide excellent customer service to all employees. Helps identify patterns developing from injuries and resulting in WC claims. Helps to track claims and run reports for management. Makes recommendations for improving the WC claim process reducing overall claim counts. Performs other duties as assigned
Minimum Requirements:
Bachelors degree in business, human resources, or related field preferred. At least 3 years of Workers' Compensation experience. Legal experience strongly preferred. Good organizational skills and attention to detail. Ability to work in a fast-paced environment. Be able to work independently and as part of a team. Ability to communicate effectively and provide excellent customer service with individuals both inside and outside of the organization. Computer proficiency, including Microsoft Office applications, required.
Maxim Benefits:
Health and Wellness Medical/Prescription, Dental, Vision, Health Advocacy (company paid if enrolled Medical) and
Health Advocate Employee Assistance Program Retirement and Financial Security:
Employee Assistance Program, Health Savings Account, 401(k) + Company Match, Profit Sharing, Short and Long Term Disability, Primary Caregiver Leave, Parental Leave, Life and Basic Accidental Death & Dismemberment Insurance, Voluntary Group Life Insurance and Supplemental Accidental Insurance, Hospital Expense Protection Plan, Critical Illness Insurance, Dependent Care Flexible Spending Account, Home and Auto Insurance discounts, Pet Insurance and Legal benefits
Lifestyle Benefits:
Paid Time Off and Company Paid Holidays, Transportation Benefits, Educational Assistance Program, College Partnership Program and Employee Discount Program Benefit eligibility is dependent on employment status. About Maxim Healthcare Maxim Healthcare has been making a difference in the lives of our patients, caregivers, employees and communities for more than 30 years. We offer private duty nursing, skilled nursing, physical rehabilitation, companion care, respite care and behavioral care for individuals with chronic and acute illnesses and disabilities. Our commitment to quality customer service, compassionate patient care, and filling critical healthcare needs makes us a trusted partner wherever care is needed. Maxim Healthcare, Inc. ("Maxim") is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.