Workers' Medical Representative?/entry-level; hybrid
Position: Workers' Compensation Medical Only Representative (entry-level; hybrid)
Location: Village of New Hartford
The Company
At Utica National Insurance Group, 1,400 employees countrywide take our corporate promise to heart every day:
To make people feel secure, appreciated, and respected.
Utica National Insurance Group is an "A" rated $1.5B award-winning, nationally recognized property & casualty insurance carrier.
Operating along the Eastern half of the United States, our Home Office is based in Central New York, with Regional Office locations including Boston, NYC, Buffalo, Atlanta, Dallas, Columbus, Richmond, and Chicago.
This is a hybrid position reporting to our New Hartford, NY location.
What you will do
The Medical Only (MO) role is a workers' compensation claims representative position. You will be responsible for handling low complexity claims that are first party and classified as medical only. In this position, you will use skills in investigation, evaluation, and negotiation to resolve claims. Communication skills will also be applied to correspond in writing and over the phone with individuals including injured workers, insureds, agents, vendors, team members, and defense counsel.
The MO role is an important step to building knowledge and skills and may support room for future growth and career pathing potential within the Workers' Compensation Department!
Key responsibilities
Receive and set up claims assignments from the insured First Notice of Loss reports.
Review incoming loss notices and assign accordingly to claim representatives within the unit or send to the appropriate regional claim office.
Investigate first party, low severity Workers Compensation medical claims.
Confirm compensability & coverage.
Communicate directly with the insureds, medical providers, agents, and vendors by telephone and in writing.
Review and approve medical treatments and associated medical bills.
Maintain strict diary on all active files.
Follow directives and instructions from Claims Supervisors and superiors.
Adhere to the WC Claims Best Practices, Workers Compensation statutes, bulletins, and attend company training classes.
Provide exceptional customer service.
Adhere to mandated state regulations.
Operate within a rules-based environment with a strong customer satisfaction emphasis.
Perform other tasks as assigned by management in relation to daily operations.
Monitor and update Medicare reporting.
What you need
College degree or equivalent experience preferred.
1-2 years of previous claims experience preferred but not required; professional customer service experience is beneficial.
Licensing
Required to obtain your license(s) as an adjuster in the state(s) in which you are assigned to adjust claims. Licensing must be obtained within the timeframe set forth by the Company and must be maintained as needed throughout your employment.
Salary range: $35,200 - $44,000
The final salary to be paid and position within the internal salary range is reflective of the employees work experience, their geographic location, education, certification(s), scope and responsibilities in the role, and additional qualifications.
Benefits
We believe strongly that talented people are core to our success and are attracted to companies that provide competitive pay, comprehensive benefits packages, career advancement and challenging work opportunities. We offer a Comprehensive Benefits Plan for full time employees that include the following:
Medical and Prescription Drug Benefit
Dental Benefit
Vision Benefit
Life Insurance and Disability Benefits
401(k) Profit Sharing and Investment Plan (Includes annual Company financial contribution and discretionary Profit Sharing contribution based upon annual company financial results)
Health Savings Account (HSA)
Flexible Spending Accounts
Tuition Assistance, Training, and Professional Designations
Company-Paid Family Leave
Adoption/Surrogacy Assistance Benefit
Voluntary Benefits - Group Accident Insurance, Hospital Indemnity, Critical Illness, Legal, Protection, Pet Insurance
Student Loan Refinancing Services
Membership with Back-up Care, Senior Solutions
Business Travel Accident Insurance
Matching Gifts program
Paid Volunteer Day
Employee Referral Award Program
Wellness programs
Additional Information:
This position is a full time hourly, non-exempt (overtime eligible) position.
Utica National is an Equal Opportunity Employer.
Apply now and find out what its like to be a part of an amazing team, thrive in an exciting environment and work for a company you can be proud of. Once you complete your application, you can monitor your status in the hiring process by logging into your profile. A representative from our Talent Acquisition team will be in touch regarding any change in your candidacy.
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Apply Now
Location: Village of New Hartford
The Company
At Utica National Insurance Group, 1,400 employees countrywide take our corporate promise to heart every day:
To make people feel secure, appreciated, and respected.
Utica National Insurance Group is an "A" rated $1.5B award-winning, nationally recognized property & casualty insurance carrier.
Operating along the Eastern half of the United States, our Home Office is based in Central New York, with Regional Office locations including Boston, NYC, Buffalo, Atlanta, Dallas, Columbus, Richmond, and Chicago.
This is a hybrid position reporting to our New Hartford, NY location.
What you will do
The Medical Only (MO) role is a workers' compensation claims representative position. You will be responsible for handling low complexity claims that are first party and classified as medical only. In this position, you will use skills in investigation, evaluation, and negotiation to resolve claims. Communication skills will also be applied to correspond in writing and over the phone with individuals including injured workers, insureds, agents, vendors, team members, and defense counsel.
The MO role is an important step to building knowledge and skills and may support room for future growth and career pathing potential within the Workers' Compensation Department!
Key responsibilities
Receive and set up claims assignments from the insured First Notice of Loss reports.
Review incoming loss notices and assign accordingly to claim representatives within the unit or send to the appropriate regional claim office.
Investigate first party, low severity Workers Compensation medical claims.
Confirm compensability & coverage.
Communicate directly with the insureds, medical providers, agents, and vendors by telephone and in writing.
Review and approve medical treatments and associated medical bills.
Maintain strict diary on all active files.
Follow directives and instructions from Claims Supervisors and superiors.
Adhere to the WC Claims Best Practices, Workers Compensation statutes, bulletins, and attend company training classes.
Provide exceptional customer service.
Adhere to mandated state regulations.
Operate within a rules-based environment with a strong customer satisfaction emphasis.
Perform other tasks as assigned by management in relation to daily operations.
Monitor and update Medicare reporting.
What you need
College degree or equivalent experience preferred.
1-2 years of previous claims experience preferred but not required; professional customer service experience is beneficial.
Licensing
Required to obtain your license(s) as an adjuster in the state(s) in which you are assigned to adjust claims. Licensing must be obtained within the timeframe set forth by the Company and must be maintained as needed throughout your employment.
Salary range: $35,200 - $44,000
The final salary to be paid and position within the internal salary range is reflective of the employees work experience, their geographic location, education, certification(s), scope and responsibilities in the role, and additional qualifications.
Benefits
We believe strongly that talented people are core to our success and are attracted to companies that provide competitive pay, comprehensive benefits packages, career advancement and challenging work opportunities. We offer a Comprehensive Benefits Plan for full time employees that include the following:
Medical and Prescription Drug Benefit
Dental Benefit
Vision Benefit
Life Insurance and Disability Benefits
401(k) Profit Sharing and Investment Plan (Includes annual Company financial contribution and discretionary Profit Sharing contribution based upon annual company financial results)
Health Savings Account (HSA)
Flexible Spending Accounts
Tuition Assistance, Training, and Professional Designations
Company-Paid Family Leave
Adoption/Surrogacy Assistance Benefit
Voluntary Benefits - Group Accident Insurance, Hospital Indemnity, Critical Illness, Legal, Protection, Pet Insurance
Student Loan Refinancing Services
Membership with Back-up Care, Senior Solutions
Business Travel Accident Insurance
Matching Gifts program
Paid Volunteer Day
Employee Referral Award Program
Wellness programs
Additional Information:
This position is a full time hourly, non-exempt (overtime eligible) position.
Utica National is an Equal Opportunity Employer.
Apply now and find out what its like to be a part of an amazing team, thrive in an exciting environment and work for a company you can be proud of. Once you complete your application, you can monitor your status in the hiring process by logging into your profile. A representative from our Talent Acquisition team will be in touch regarding any change in your candidacy.
#J-18808-Ljbffr
Apply Now