Claims Technician, Workers Compensation - Central Region

$36,900 - $60,700/Yr

Liberty Mutual - Hoffman Estates, IL

Full-time - Entry Level

Onsite - Hoffman Estates, IL

Insurance Carriers and Related Activities

About the position

Liberty Mutual Insurance is seeking a dedicated Workers Compensation Claims Technician to join our fast-growing claims team. This role is essential in processing routine workers' compensation claims while providing ongoing medical management for medical pension claims. As a Claims Technician, you will be responsible for obtaining vital information from injured workers, employers, and medical providers to ensure accurate and timely claims processing. You will play a crucial role in delivering quality service to injured workers and customers, ensuring they receive the necessary support throughout the claims process. In this position, you will conduct thorough investigations to gather essential facts regarding workers' compensation claims through both telephone and written communication. You will verify information from claimants, physicians, and medical providers to assess the compensability of claims and make informed evaluations for cases requiring ongoing medical management. Your responsibilities will also include maintaining contact with injured workers, providers, and employers to ensure a clear understanding of protocols and claims processing, as well as addressing any medical treatment issues that may arise. Additionally, you will be tasked with arranging Independent Medical Exams and Peer Reviews as necessary, maintaining accurate records, and handling administrative responsibilities associated with claims processing and payment. This role requires effective analytical skills to recognize questionable coverage situations and the ability to communicate decisions clearly to customers. You will also be responsible for generating form letters and documenting all relevant information in accordance with file posting standards. This position may have in-office requirements depending on the candidate's location, and candidates must reside within 50 miles of Hoffman Estates, IL, or Indianapolis, IN, with remote work options available for certain states.

Responsibilities

• Conduct investigation to secure essential facts from injured workers, employers, and providers regarding workers' compensations through telephone or written reports.
• Verify information from claimants, physicians, and medical providers to assess compensability and/or causal relation of medical treatment and make evaluations for cases with claim-specific ongoing medical management.
• Provide ongoing medical case management for assigned claims.
• Initiate calls to injured workers and medical providers if projected disability exceeds maximum triage model projection or to resolve medical treatment issues as needed.
• Maintain contact with injured worker, provider, and employer to ensure understanding of protocols and claims processing and medical treatment.
• Continually assess claim status to determine if problem cases or those exceeding protocols should be referred to the Claims Service Team and/or would benefit from MP RN review or other medical/claims resources.
• Arrange Independent Medical Exams and Peer Reviews as necessary.
• Maintain accurate records and handle administrative responsibilities associated with processing and payment of claims.
• Record and update status notes; document results of contacts, relevant medical reports, and duration information per file posting standards including making appropriate medical information viewable to customers in Electronic Document Management (EDM).
• Generate form letters following set guidelines (i.e., letters to physicians projecting disability, letters confirming medical treatment and disability, and letters outlining expected outcomes to employers).

Requirements

• High school diploma plus 1-3 years of related customer service experience or applicable insurance knowledge.
• Effective analytical skills required to learn and apply basic policy/contract coverage and recognize questionable coverage/contract situations.
• Effective interpersonal skills to explain the facts and logic used to arrive at decisions in a way that the customer understands.
• Effective written skills to compose clear, succinct descriptions when posting files and drafting correspondence.
• Good telephone and typing skills required.
• Ability to learn when to make proper use of medical management resources, know when to use them and follow through with medical management information received.

Benefits

• Competitive salary range based on skills, experience, education, certifications, and location.
• Opportunities for commission and/or bonus earnings based on performance.
• Comprehensive benefits that support life and well-being.