[Hiring] Claims Representative @Dollar General

Role Description

Investigate, evaluate, negotiate, and resolve workers’ compensation claims with minimal supervision.

• Conduct interviews with injured employees, store personnel, and medical care providers within 24 hours of receiving reported incident.
• Utilize complex problem solving, critical thinking skills, and strong organization skills to timely evaluate compensability and management of claim assignments.
• Maintain communication with appropriate parties throughout life of file for proper medical and disability management and resolution. (20%)
• Utilize professional experience and investigative skills to evaluate monetary exposure of claim and ability to establish action plan to include medical, disability management, and resolution. (20%)
• Proactively and timely coordinate and communicate with doctor, injured employee, and store personnel for light duty or full duty return to work, payment of appropriate benefits, and properly utilize in-house and field nurse resources for medical and disability management. (15%)
• Ability to timely evaluate requests for medical care regarding causation and relatedness and in compliance with state requirements.
• Timely evaluate and pay medical and indemnity benefits in accordance with the law. Complete appropriate state reporting. (15%)
• Coordinate and communicate with service providers such as defense attorneys, medical case managers, and private investigators to minimize claim expense and maximize results. (10%)
• Develop and maintain a proactive strategic plan of action for the life of the file and resolve claims and make recommendations for claim resolution efficiently and within best practice expectations, and state requirements. (10%)
• Maintain a working knowledge of multiple state workers’ compensation laws and statutes and maintain appropriate state required licensing. (10%)

Qualifications

• Extensive claim handling experience with emphasis on workers’ compensation.
• Possess complex problem solving and strong decision-making skills.
• Strong organizational skills and the ability to prioritize.
• Customer service oriented and works well in a team environment.
• Excellent written and verbal communication skills.
• Must be detail oriented and able to meet deadlines.
• Ability to handle confrontational situations in a mature and professional manner.
• Working knowledge of medical and legal terminology.
• Working knowledge of Microsoft Office programs.

Requirements

• Extensive insurance claims background and experience with emphasis on workers’ compensation.
• 1-2 years of related experience preferred.
• College degree preferred but not required.
• Equal education and experience may be considered.

Benefits

• This is a Remote role with a base compensation of $67,000.