Workers Compensation Claims Specialist - Remote

Aveanna Healthcare - Atlanta, GA

Full-time

Remote - Atlanta, GA

Nursing and Residential Care Facilities

About the position

The Workers Compensation Claims Specialist serves as a crucial link between Aveanna's Field Staff and the third-party administrator, ensuring effective management of workers' compensation claims. This role involves investigating claims, reviewing medical reports, and ensuring that claims are resolved according to established best practices and protocols, all while delivering excellent customer service.

Responsibilities

• Investigating, reviewing, evaluating, and administering workers' compensation claims
• Reviewing medical reports
• Setting reserves
• Filing documentation
• Reviewing and approving medical bills for payment
• Reviewing accident and injury reports
• Interviewing and corresponding with claimants, witnesses, attorneys, and physicians
• Approving claims or recommending denial
• Representing Aveanna at various workers' compensation and industrial leave claims actions and hearings
• Performing other duties as assigned

Requirements

• High School Diploma and 5 years or more experience in Claims and Litigation OR a Bachelor's Degree and 4 years' experience in Claims and Litigation
• Knowledge of claims handling and legal statutes and procedures
• Customer service experience
• Workers Comp experience in California, Texas, and Pennsylvania and non-subscriber claim experience highly preferred

Nice-to-haves

• Attention to detail
• Time Management
• Effective problem-solving and conflict resolution
• Good organization and communication skills