Job Description:

Coventry


Workers' Comp Claims Adjustor

US-MO-Jefferson City

Job ID: 24-17408
Type: Regular Full-Time
# of Openings: 1
Category: Customer Service & Support
Mitchell International, Inc.

Overview

The Enlyte Family of Businesses

Mitchell | Genex | Coventry

Enlyte is the parent brand of Mitchell, Genex and Coventry, an organization unlike any other in the Property & Casualty industry, bringing together three great businesses with a shared vision of using technology innovation, clinical services and network solutions to help our customers and the people they serve. Our suite of products and services enable our employees to help people recover from challenging life events, while providing opportunities for meaningful impact and career growth.

Responsibilities

This is a full-time, on-site opening. and is contracted with the state of Missouri.

Perks: Full and comprehensive benefits program, 24 days of paid vacation/holidays in your first year plus sick days, home office equipment including laptop and desktop monitor, Employee Assistance and Referral Program.

The Tech shall provide the claims adjusting services listed below, related to time lost claims, as directed by the state agency. The Tech shall understand and agree that the determination of a compensable injury will be the responsibility of the state agency. The Tech's services, related to time lost or litigated claims shall include, at a minimum, the following:

• • Reviewing and investigating claims necessary to process under workers’ compensation;
  • Reviewing injury reports to determine appropriate medical referrals;
  • Assisting injured State of Missouri workers in scheduling and arranging medical examinations;
  • Monitoring treatment and processing payment of benefits
  • Reviewing medical records and bills for casual relationship, reasonableness, and authorized treatment and then processing for payment within three weeks of receipt of bill and/or documentation
  • Contact injured State of Missouri workers within four business days of case assignment, in order to review benefits and obtain additional information
  • Calculating benefits with accuracy and maintaining appropriate reserves in accordance with procedures established by the state agency;
  • Reviewing medical records, documenting files, and providing copies for the Missouri Assistant Attorney General within two weeks of receipt;
  • Ensuring temporary modified duty work slips are documented and provided to the state agency within 24 hours of receipt, to meet the established Early Return to Work program objectives

  • Position entails working on site with State of Missouri as a contracted employee.

Qualifications

• High School diploma or equivlant.
• Experience in a fast-paced, production environment.
• Claims experience preferred
• Customer Service experience in a transaction based environment such as a call center or retail location preferred, demonstrating ability to be empathetic and compassionate.
• Demonstrated ability to handle multiple assignments competently, accurately and efficiently.
• Ability to write clearly and effectively when communicating with all parties.

Salary:

PI255344509

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