Claims Assistant - Workers' compensation

## Claims Assistant - Workers compensation

**POSITION SUMMARY:**Under close supervision performs clerical and data entry tasks that assist in administration of workers’ compensation claims. This position requires considerable interaction with claimants on the phone, and with management, other Claims Examiners, and other TRISTAR staff in the office; therefore, consistently being at work in their home office, in a timely manner, is inherently required of this position.

**DUTIES AND RESPONSIBILITIES:**

• Sets up new claims in system and paper files, ensuring all documentation is present and correct.
• Prepares, schedules, and processes benefit and medical payments on claim files as directed by the Claims Examiner.
• Documents all work product and claim activity in the electronic claim file.
• Prepares and prints letters, benefit notices and labels.
• Provides clerical support, including filing, faxing, sorting, photocopying, and alphabetizing.
• Communicates pertinent claim information to the client, legal counsel, medical and rehab providers and internal claims staff.
• Answers phone calls, take messages and responds appropriately.
• Other duties as assigned.

**\***Essential job function.
**EQUIPMENT OPERATED/USED:**Computer, telephone, 10-key, fax machine, printers and other basic office equipment.
## Qualifications
**QUALIFICATIONS REQUIRED:**
Education/Experience: High school diploma or GED, and one (1) year experience in the workers’ compensation claims industry (preferred).
**Knowledge, Skills and Abilities:**

• Proficient keyboarding skills (type 45 wpm).
• Working knowledge of medical/legal terminology.
• Ability to alphabetize and collate.
• Proficient in Word.
• Ability to follow written and spoken instructions from several individuals.
• Ability to produce accurate and detailed work.
• Excellent verbal and written communication skills.
• Courteous telephone skills.
• Ability to effectively prioritize multiple projects and due dates.
• Ability to work independently, as well as in cooperation with workgroup.

Mental and Physical Requirements: [see separate attachment for a copy of checklist of mental and physical requirements]

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| | **MENTAL AND PHYSICAL REQUIREMENTS** | | |

| | **1. MENTAL EFFORT** a. Reasoning development: Follow one- or two-step instructions; routine, repetitive task. Carry out detail but uninvolved written or verbal instructions; deal with a few concrete variables. Follow written, verbal, or diagrammatic instructions; several concrete variables. X Solve practical problems; variety of variables with limited standardization; interpret instructions. Logical or scientific thinking to solve problems; several abstract and concrete variables. Wide range of intellectual and practical problems; comprehend most obscure concepts. | | |

| | b. Mathematical development: Simple additional and subtraction; copying figures, counting, and recording. Add, subtract, multiply, and divide whole numbers. X Arithmetic calculations involving fractions, decimals, and percentages. Arithmetic, algebraic, and geometric calculations. Advanced mathematical and statistical techniques such as calculus, factor analysis, and probability determination. &nbsp | | |