Workers' Compensation Associate Claim Representative - Eastern Alliance

Responsibilities

• 35% - Responds to calls from policyholders, injured workers and providers and directs medical care, where jurisdictionally appropriate, for the unassigned medical only claims.
• 20% - Reviews medical invoices for unassigned medical only claims. Contacts insureds, injured workers and/or medical providers as necessary to investigate and approve appropriate invoices for payment within established timeframes.
• 5% - Assist with special projects as assigned.
• 5% - Travel to customer, agency and industry meetings occasionally.
• 5% - Participate in department meetings and other duties as assigned.

Requirements

• Bachelor's degree is preferred; a HS Diploma/GED with a minimum of eight years of experience working in a medical, legal or an insurance environment can replace the degree requirement.
• Basic knowledge of medical terminology, common medical procedures and treatments preferred.
• Some knowledge of applicable state laws and industry standards preferred.
• Ability to attend insurance and industry/business functions to promote and present a positive image of the Company.
• Proficiency in Microsoft Office computer applications; ability to learn new computer software applications.
• Empathic listener with the ability to listen and respond to another person in a way that engenders mutual understanding and tru

Benefits

Additional Information

An exciting opportunity exists to join the ProAssurance family of companies! Our mission is powerful and simple: We protect others. Choosing a place to apply your talents is an important decision for anyone. You have plenty of options. Why choose ProAssurance? At ProAssurance, we sell a pledge, and that pledge is delivered by our team members. We are seeking individuals who value integrity, leadership, relationships, and enthusiasm-and want to build their career with a great company where they can be their authentic self and feel valued, recognized, and rewarded for their contributions. ProAssurance specializes in healthcare professional liability, products liability for medical technology and life sciences, legal professional liability, and workers' compensation insurance. We are an industry-leading specialty insurer, with job opportunities in much of the contiguous United States. This position supports our workers' compensation line of business, Eastern Alliance, and is hybrid, reporting to the Lancaster PA office location approximately 2 days per month. The primary responsibility of this position is to consistently execute the Company's ecovery® Return to Wellness philosophy and business model that leads to better outcomes for our injured workers and insureds. Responsibilities of this position include managing the unassigned medical only claims in the region and all aspects of assigned claims, including verifying coverage, investigating, managing, and resolving non-complex workers' compensation claims for the Company's customers under direct supervision, following established Company requirements and procedures, and promptly establishing and maintaining accurate reserves. Actively participate in training opportunities for promotion into other positions within the regional claim organization or to excel in this position.

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