Job description

• Set up and manage medical files only in accordance with corporate claim standards and law

• Establish reserves and/or provide reserve recommendations within established authority levels under direct supervision

• Review and approve related medical and miscellaneous invoices on designated claims

• Negotiate any disputed bills/invoices for resolution under direct supervision

• Request and monitor medical treatment of designated claims in accordance with corporate claim standards

• Summarize all correspondence and medical records in claim log notes as well as file same in the appropriate claim

• Close claim files when appropriate

• Retrieve closed claim files and re-file in storage, as requested

• Provide support to claim staff on client service teams

• Compliance with Corporate Claim Standards and special client handling instructions as established

• Performs other duties as assigned

• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily

• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions

Job Type: Full-time

Pay: $55,000.00 - $70,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Flexible schedule
• Health insurance
• Paid time off
• Vision insurance

Physical setting:

• Office

Schedule:

• 8 hour shift
• Monday to Friday

Experience:

• Future Medical Claims Adjusting: 2 years (Required)
• Medical Only Claims Adjusting: 2 years (Required)

License/Certification:

• California SIP License (Preferred)

Work Location: Remote

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