Piscataway, United States
about 1 year ago
This is an entry-level trainee position that works under direct supervision. The Medical Only Adjuster is responsible to investigate, evaluation, processing of workers compensation claims with no lost time as defined by statue.
KEY RESPONSIBILITIES: (Duties may include, but not limited to all or some of the following)
Work closely with injured employee, employer and managed care Rn/treating physician within 48 hours.
Provide timely and accurate information in the claim system of name of person contacted, date of contact and briefly the facts developed. Investigate the facts of the claim and make a decision regarding compensability with help Supervisor
Handle files within your reserve and settlement authority.
Process all lost and expense payment.
Ensure all payments are made promptly and in accordance to regulations for the jurisdiction.
Enter codes and verifies data for claims processing.
Assigned to the field investigator for GOTCHA visitation within the Account specific timeframe.
Medicare-eligible identification and updates in claim codes.
Performs other duties as assigned.