Claims Support Assistant II
About The Position
At EMC, we’re all about working together to make an impact. As part of our team, you’ll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts—always supporting each other to do our best work. Join us, and let’s improve lives together. This position is eligible to work from home anywhere in the United States Essential Functions: Assists WC department with the handling of claim tasks as needed Issues medical records payments once approved by the adjuster Attends and participate in team meetings as appropriate Attends internal and external training and self-study to stay informed of changes impacting the WC department Assists team members as needed, including training less experienced team members on support incident only workflow and specific jurisdictional duties Assists with special projects as required Reviews and supports incident only workflow and specific jurisdictional duties Reviews the claim notice, confirms self-care claim and/or incident only claim status Ensures timely communication to insureds by sending an acknowledgement notice Reviews incident only claims with change to status and moves for claim assignment Maintains accurate diaries on all incident only claims, moves to closure if no activity within designated time frame Reviews reopened claims with WC claims support team members to determine the appropriate claim handler based on best practices Provides accurate file documentation on all claims and tasks Processes split funded payments to Sedgwick and ensures split funded claims are handled in accordance with EMC’s claim guidelines Reviews split fund claims and prepares for payment Sets designated reserves on split claims up to assigned threshold Reviews reopened claims with WC claims support team members to determine the appropriate claim handler based on best practices.
Requirements
- High school degree or equivalent
- Two years of experience of workers’ compensation claims support or related experience
- Good knowledge of workers compensation insurance and claims terminology
- Good computer skills, including Microsoft Office
- Accurate data entry skills
- Ability to file alpha and numeric information accurately
- Strong human relations and customer service skills
- Excellent verbal and written communication skills
- Strong organizational skills
- Good attention to detail skills
Responsibilities
- Assists WC department with the handling of claim tasks as needed
- Issues medical records payments once approved by the adjuster
- Attends and participate in team meetings as appropriate
- Attends internal and external training and self-study to stay informed of changes impacting the WC department
- Assists team members as needed, including training less experienced team members on support incident only workflow and specific jurisdictional duties
- Assists with special projects as required
- Reviews and supports incident only workflow and specific jurisdictional duties
- Reviews the claim notice, confirms self-care claim and/or incident only claim status
- Ensures timely communication to insureds by sending an acknowledgement notice
- Reviews incident only claims with change to status and moves for claim assignment
- Maintains accurate diaries on all incident only claims, moves to closure if no activity within designated time frame
- Reviews reopened claims with WC claims support team members to determine the appropriate claim handler based on best practices
- Provides accurate file documentation on all claims and tasks
- Processes split funded payments to Sedgwick and ensures split funded claims are handled in accordance with EMC’s claim guidelines
- Reviews split fund claims and prepares for payment
- Sets designated reserves on split claims up to assigned threshold
- Reviews reopened claims with WC claims support team members to determine the appropriate claim handler based on best practices
Benefits
- More than 105 years of financial strength and stability
- Named a five-star insurance carrier by Insurance Business America
- Two-time recipient of the Best Practices Award of Excellence from the Independent Agents & Brokers of America
- Multiple locations recognized as Top Workplaces based solely on team member feedback
- Corporate culture that engages and empowers team members to achieve their best
- Outstanding benefits with life, medical, dental, vision and prescription drug coverage
- Competitive paid time off plan and a full day of volunteer time off annually
- Financial incentives, including a 401(k) plan match, pension plan, OneEMC bonus plan and recognition and anniversary awards
- Professional development and growth opportunities, including tuition reimbursement
- Wellness initiatives to improve team member well-being and reduce health insurance costs
- Flexibility to dress for your day and opportunities for alternative work arrangements
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
