Pulmonary Medicine Associates
Pulmonary Medicine Associates

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In this position you will administer and resolve highest risk management expectations claims in a ... Demonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of ...

In this position you will administer and resolve highest risk management expectations claims in a ... Demonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of ...

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Associate Claims Specialist - Medical Only - Tampa, FL

PMA Companies

Tampa, FL • On-site

$16.25 - $21.75/hr

Other

Posted 10 days ago


Job description

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Associate Claims Specialist - Medical Only
#4826
Multiple Locations
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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.
Requirements:
  • High school diploma or equivalent
  • One or more years of Workers Compensation claims handling experience
  • License required or ability to obtain license within 90 days of employment in mandated states -FL, GA, AL
  • Familiarity with medical terminology
  • Ability to work independently, handle multiple tasks simultaneously, make difficult decisions and focus on details
  • Strong organizational skills
  • Excellent verbal and written communication skills
  • Proficiency MS Excel and MS Word.
Alternate Location(s)
Montgomery, Alabama, United States
Ft Lauderdale, Florida, United States
Jacksonville, Florida, United States
Miami, Florida, United States
Orlando, Florida, United States
Tampa, Florida, United States
Atlanta, Georgia, United States
Augusta, Georgia, United States
Savannah, Georgia, United States
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About Pulmonary Medicine Associates

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Pulmonary Medicine Associates is a premier pulmonary, critical care, and sleep medicine practice in Roseville and Sacramento, California. With a variety of medical specialists, the practice cares for patients of all ages: babies, children, teenagers, and adults. Pulmonary Medicine Associates offers a broad spectrum of specialized services in outpatient, inpatient, and telemedicine settings. The practice has longevity in the community, serving patients for more than 50 years. The outstanding providers are dedicated to achieving the finest quality of care in a comfortable, welcoming setting. In addition to sleep medicine, pulmonary care, and critical care services, Pulmonary Medicine Associates offers infectious disease treatments, wound care, transitional care, travel medicine, neurocritical care, palliative care, and much more. The practice also provides hyperbaric oxygen therapy and has a sleep lab for sleep studies. Patients struggling with sleep disorders, chronic obstructive pulmonary disease (COPD), lung diseases, infectious diseases, non-healing wounds, and severe injuries or illnesses can rely on Pulmonary Medicine Associates for superior care. The compassionate providers personalize each treatment to a patient’s needs and offer the latest advances in technologies and procedures. They enjoy helping patients sleep better, heal and recover faster, experience less pain, breathe easier, and have the best quality of life possible at every stage. The Pulmonary Medicine Associates experts welcome new and existing patients and look forward to serving them. Schedule an appointment at Pulmonary Medicine Associates by phone or request one online today.

Industry

Hospitals

Company size

51 - 200 Employees

Headquarters location

Roseville, CA, US

Year founded

1973