ESSENTIAL RESPONSIBILITIES:
- Understands and consistently applies customer service concepts and requirements.
- Conducts thorough initial investigations to determine coverage, compensability, subrogation, and fraud.
- Understands basic anatomy and medical terminology. Able to read and evaluate medical reports to determine extent of injury and treatment plans. Able to recognize, research, and analyze complex medical issues.
- Implements pro-active direction and control with timely intervention and action planning.
- Understands basic reserving concepts and adheres to company reserving guidelines.
- Effectively utilizes managed care cost containment programs, services, and vendors. Consistently provides direction to assure control of costs.
- Recognizes and aggressively pursues all potential subrogation recovery opportunities.
- Understands and consistently applies legal and statutory concepts of the applicable jurisdiction.
- Provides consistent meaningful file documentation with effective use of the queue and calendar system.
- Demonstrates superior communication skills in all aspects of the position. Places emphasis on meaningful correspondence and effective customer service interactions.
- Conducts Claim Reviews independently with Insureds and Agents.
- Demonstrate interest and ability to handle increasingly more complex issues.
- Maintain a positive attitude and exhibit consistent professionalism.
- Demonstrate creativity and independently conduct research.
- Regular and predictable attendance.
- Performs other duties as assigned.
EDUCATION:
College degree preferred.
EXPERIENCE:
Minimum 2-3 years of experience in handling Workers' Compensation claims preferred.
OTHER QUALIFICATIONS:
- Thorough understanding of personal computing, typing skills, technology and use of mobile devices.
- Basic understanding of medical terminology and treatment, physiology, and anatomy.
- Understanding of WC statutes and case law.
- Someone who has demonstrated sustained excellence over a prolonged period of time.
- Excellent written and verbal communication skills.
- Independently conducts claim reviews & service presentations to agents and potential new insureds.
- Independently handles litigated claims including attending prehearings, mediations, and hearings.
- Has served as a mentor for a new employee or willingness to do so by volunteering with job shadowing and training activities.
- Participates in or conducts a training session for unit and/or department.
- Has accompanied SIU on field claim investigations.
- Ability and willingness to provide quality customer service.
- Must be a self-starter, take on and create new opportunities.
- Ability to work both independently and in collaboration with others.
- Proven organizational and time management skills.
*Acuity does not sponsor applicants for U.S. work authorization.*
This job is classified as exempt.
The salary range for this position is $75,000 - $90,000 annually. This salary range is an estimate, and the actual salary will vary based on applicant's education, experience, knowledge, skills, and abilities.
For this role, Acuity offers a comprehensive benefits package, including a generous 401(k) contribution, medical, dental, vision, life and disability insurance, paid time off, an Employee Assistance Program, and more. A full description of benefits and eligibility will be provided to candidates during the hiring process.
Acuity will include at least one in-person interview during the hiring process for all positions.
