Remote Medical Claims Processor Jobs in Waukee, IA

Job Description:

Creative Risk Solutions (CRS), a proud line of business under the Holmes Murphy umbrella, is a leading Third-Party Administrator (TPA) specializing in innovative claims management solutions. At CRS, we believe in doing things differently-empowering our team to deliver exceptional service, embrace creativity, and make a real impact for our clients. We are looking to add a Workers' Compensation Claims Specialist to join our team. Experience handling claims in Maine, Connecticut, and New Jersey is required.

Essential Responsibilities:

• Receives, gathers and accurately transmits workers' compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner.
• Investigates, evaluates, and resolves lost time Workers' Compensation claims, including litigated claims.
• Mediates situations as they arise between the insured and the insurance company, with little to no support from leader, to include researching coverage issues.
• Enters and maintains accurate information on a computer system during the claim process, to include final settlement information.
• Generates checks for indemnity and medical payments daily.
• Develops and monitors consistency in procedural matters of claims handling process within CRS.
• Willingness to become licensed if required in jurisdiction where claims are handled.

Qualifications:

• Education: High school diploma; college degree preferred. Technical designations encouraged, such as AIC and CPCU.
• Experience: 3-5 years claims experience with strong background in Workers' Compensation claims handling. Prior experience handling Maine, Connecticut, and New Jersey claims is required.
• Licensing: ActiveMaine, Connecticut, and/or New JerseyWorkers' Compensation License required or the ability to acquire license within three months of hire.
• Skills: An ideal candidate will have proficient knowledge of Workers' Compensation insurance coverage and claims processing procedures. They will possess the ability to adjudicate lost time claims across multiple jurisdictions and demonstrate the capacity to quickly learn and adapt to various software programs.
• Technical Competencies: An ideal candidate will have a strong grasp of claims principles, practices, and insurance coverage interpretation, contributing to workflows and adhering to compliance requirements. They will prioritize problem-solving, actively foster relationships, and collaborate to deliver impactful solutions and a world-class client experience.

Here's a little bit about us:

Creative Risk Solutions is a leading provider of innovative risk management solutions. We specialize in delivering customized claims management, loss control, and risk consulting services to our clients. Our team is dedicated to excellence, integrity, and creating value for our clients through proactive risk management strategies. In addition to being great at what you do, we place a high emphasis on building a best-in-class culture. We do this through empowering employees to build trust through honest and caring actions, ensuring clear and constructive communication, establishing meaningful client relationships that support their unique potential, and contributing to the organization's success by effectively influencing and uplifting team members.

Benefits: In addition to core benefits like health, dental and vision, also enjoy benefits such as:

• Paid Parental Leave and supportive New Parent Benefits - We know being a working parent is hard, and we want to support our employees in this journey!
• Company paid continuing Education & Tuition Reimbursement - We support those who want to develop and grow.
• 401k Profit Sharing - Each year, Holmes Murphy makes a lump sum contribution to every full-time employee's 401k. This means, even if you're not in a position to set money aside for the future at any point in time, Holmes Murphy will do it on your behalf! We are forward-thinking and want to be sure your future is cared for.
• Generous time off practices in addition to paid holidays - Yes, we actually encourage employees to use their time off, and they do. After all, you can't be at your best for our clients if you're not at your best for yourself first.
• Supportive of community efforts with paid Volunteer time off and employee matching gifts to charities that are important to you - Through our Holmes Murphy Foundation, we offer several vehicles where you can make an impact and care for those around you.
• DE&I programs - Holmes Murphy is committed to celebrating every employee's unique diversity, equity, and inclusion (DE&I) experience with us. Not only do we offer all employees a paid Diversity Day time off option, but we also have a Chief Diversity Officer on hand, as well as a DE&I project team, committee, and interest group. You will have the opportunity to take part in those if you wish!
• Consistent merit increase and promotion opportunities - Annually, employees are reviewed for merit increases and promotion opportunities because we believe growth is important - not only with your financial wellbeing, but also your career wellbeing.
• Discretionary bonus opportunity - Yes, there is an annual opportunity to make more money. Who doesn't love that?!

The salary range for this role is $57,500- $98,900. Compensation is based on several factors, including, but not limited to, education, work experience and industry certifications. In addition to your salary, Holmes Murphy offers a comprehensive total rewards program including annual bonuses, total wellbeing benefits and support for professional development.

Holmes Murphy & Associates is an Equal Opportunity Employer.

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