Claims Associate - Medical Only Claims
Company: PMA Companies
Location: Schaumburg
Posted on: May 15, 2023
Job Description:
As a member of our Claims team, you will proactively manage
medical only and limited lost time claims in order to minimize
losses, manage permanent total claims in order to minimize losses,
and provide superior customer service. Responsibilities:
- Contact accounts on First Notices of Loss to obtain missing
information pertinent to file set-up
- Process payments, answer phone calls, authorize treatment
associated with Medical Only claims
- Complete appropriate contacts within 24 hours of assignment,
and establish and maintain appropriate diary for follow-up
- Determine whether treatment is appropriate and causally related
to the compensable injury
- Redirect treatment to network physicians as appropriate
- Refer subrogation potential claims or potential permanency
claims to Supervisor
- Work to ensure compliance with all appropriate jurisdictional
requirements on Medical Only claims, including timely form filing
if applicable
- Maintain a working knowledge of jurisdictional requirements and
obtain/maintain state adjusting licenses
- Administer benefits on Permanent Total or Death cases, which
includes monitoring for changes in life or work status, implied
interest in resolution or marked increases in costs.
- Demonstrate commitment to Company's Code of Business Conduct
and Ethics, and apply knowledge of compliance policies and
procedures, standards and laws applicable to job responsibilities
in the performance of work.
Keywords: PMA Companies, Schaumburg , Claims Associate - Medical Only Claims, Healthcare , Schaumburg, Illinois
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