Examines claims data and conducts investigations into routine and moderately complex workers compensation claims to determine coverage, compensability, subrogation, and benefits.
Verifies coverage, initiates contact with relevant parties, handles catastrophic claims with oversight, and manages litigation on assigned files.
Sets reserves within authority limits, reviews medical bills for causal relationship, and coordinates return to work (RTW) efforts with target dates.
Prepare and organize workers’ compensation case files for filing.
Accurately enter and update data in the case management system.
Perform administrative tasks related to pre-filing case preparation.
Abramson Labor Group is a leading employment and workers' compensation law firm dedicated to advocating for employees' rights. They are determined in representing workers who have faced discrimination, harassment, wrongful termination, wage disputes, and workplace injuries.
Analyze and evaluate worker’s compensation claim payments using EnableComp’s proprietary software, systems and tools.
Research, request and acquire all pertinent medical records, implant manufacturer’s invoices and any other supporting documentation necessary and then submit with hospital claims to insurance companies to ensure prompt correct claims reimbursement.
Conduct timely and thorough telephone follow-up with payers to ensure claims with supporting documentation have been received and facilitate prompt reimbursement.
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM ™ intelligent automation platform to improve financial sustainability. EnableComp is a multi-year recipient the Top Workplaces award and was recognized as Black Book's #1 Specialty Revenue Cycle Management Solution provider in 2024.
Open insurance claims and serve as the primary liaison with adjusters and carriers.
Request, track, and organize medical records, bills, and police reports.
Ensure treatment progression and awareness of treatment outcomes.
EvenUp uses technology and AI with the mission to close the justice gap. It empowers personal injury lawyers and victims to get the justice they deserve and is backed by top VCs. They are one of the fastest-growing vertical SaaS companies.
Evaluate coverage issues and risk transfer opportunities.
Manage litigation by proper selection, planning, budgeting and partnership with counsel.
Effectively communicate exposures both internally and externally.
AmTrust Financial Services is a fast-growing commercial insurance company. They strive to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected and value excellence.
Maintain ongoing caseload of individuals to promote engagement and achievement of health goals.
Use relationship-based strategies to support members with social support navigation.
Assist individuals in securing connection to community supports by scheduling appointments, managing referrals, and ensuring timely follow-ups.
Pair Team is an innovative, mission-driven company reimagining how Medicaid and Medicare serves the most underserved populations. As a tech-enabled medical group, they deliver whole-person care - clinical, behavioral, and social - in partnership with community organizations. Their model empowers clinicians and care teams to provide compassionate, high-impact care and leverages AI and automation to reduce administrative burden.
Receive, Track, Identify and analyze claims data and clinical information as appropriate for the pre-renewal, medical underwriting, and cost containment processes.
Accurate setup of incoming and outgoing referral and review documents, utilizing medical underwriting and cost containment platforms including intake logs, Conexure, Access, Sharepoint, OneDrive, etc.
Communicate verbally and in writing of all activities and problems within assigned area of responsibility with team and manager.
Crum & Forster (C&F) provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. Its most valuable asset is its people: more than 2000 employees in locations throughout the United States and they are winning recognition as a great place to work.
Answer client telephone inquiries about their claims.
Process claims and invoicing Veterans Affairs Canada.
Provide quality assurance for claims/invoices processed by other Claims Specialists.
WCG partners with governments and local agencies across Canada to create sustainable employment opportunities for people, businesses and communities. They understand that work gives hope, strengthens relationships, and drives economic growth.
Initiating courtesy calls to clients upon case assignment, providing detailed explanations of the reduction process.
Meticulously logging phone calls, case statuses, and documents into the online document management software.
Ensuring efficient linkage of releases onto Litify, confirming PIP benefits, and validating damages with a complete provider list.
The Ward Law Group is recognized as one of the Best Places to Work for consecutive years. They serve their community with compassion and excellence, empowering their employees to deliver real results for their clients in a collaborative, innovative, and high-accountability environment.
Investigate and resolve Homeowners claims with minor to moderate complexity efficiently.
Use imagery and video tech to collaborate with vendors/insureds, identifying damage and writing virtual estimates.
Communicate effectively with insureds/representatives to resolve issues and ensure satisfaction, adhering to requirements.
Mercury has been helping people reduce risk and overcome unexpected events for over 60 years. They are one team and embrace diverse perspectives to serve customers, offering growth and fun while working together to achieve great things.
Investigates new claims and gathers information regarding injuries or loss.
Manages an inventory of property/casualty and disability claims, and negotiates settlements within prescribed limits.
Establishes accurate loss cost estimates using available resources, special service instructions, and market protocols.
Liberty Mutual strives to create a workplace where everyone feels valued and supported. They offer comprehensive benefits, workplace flexibility, and professional development opportunities, fostering an inclusive culture where employees can thrive and make a meaningful impact.
Provides employee relations support to management by representing, overseeing, or directly handling investigations, grievances, arbitration, administrative hearings, bargaining and coaching.
Advise managers and supervisors on employment and labor issues and conduct training.
Assure consistent application of Crestwood policies.
Crestwood is committed to creating innovative recovery programs and developing compassionate communities that support each client in their journey. Their model of care focuses on a personal and self-directed process that empowers the people they serve and helps them to develop the skills to thrive!
Review claim files to determine potential coverage and develop collection strategies with insurance partners, customers, and other parties.
Effectively negotiate with responsible parties and interpret the facts of loss in conjunction with debtor feedback in order to establish settlement strategy.
Initiate appropriate verbal and written communication for the ultimate recovery and make appropriate internal and external contacts to obtain necessary information.
Enterprise Mobility is building a team to be the world's best and most trusted mobility company. They operate a global network with 80,000 dedicated team members across nearly 100 countries, and more than 2.1 million vehicles taking our customers where they want to go.
Investigate and resolve insurance claim denials with speed and accuracy.
Partner with payers to resolve issues and secure timely reimbursement.
Provide top-tier phone support to patients, insurance companies, and internal teams.
IVX Health is a national provider of infusion and injection therapy for individuals managing complex chronic conditions. We’re transforming the way care is delivered with a focus on patient comfort and convenience and believe the best patient experience starts with a great employee experience.
Coordinate and implement medical case management to facilitate case closure.
Assess appropriate utilization of medical treatment and services.
Review medical records and assess data to ensure appropriate case management process.
Berkley Medical Management Solutions (BMMS) provides managed-care service for W.R. Berkley Corporation, focusing on injured worker’s return to work. BMMS was started in 2014 and combines clinical practices, return-to-work strategies, and software for workers’ compensation cases.
Independently investigates, evaluates, negotiates, and resolves large and complex commercial property and reinsured cyber claims, including litigated matters.
Analyzes coverage, cause of loss, and business income exposure; establishes timely and adequate reserves while coordinating experts and vendors.
Manages litigated claims, develops negotiation strategies, and communicates claim status and resolution strategies with insureds, agents, and internal partners.
EMC is an insurance carrier providing property and casualty insurance with over 105 years of financial strength and stability. The company fosters a corporate culture that engages and empowers team members, operates multiple locations recognized as Top Workplaces, and maintains a comprehensive rewards package for its employees.
Handle work comp claims with minimal supervision and guidance from the manager; utilize current Claims technology.
Negotiate settlements with insureds, claimants and attorneys; responsibilities also include active file management, ensuring proper reserving, presentation of claims to Committee and supervision of litigated files.
Consistently exhibit a high level of customer service and adherence to department audit guidelines.
West Bend is recognized as a Milwaukee Journal Sentinel Top Workplace for 14 consecutive years. They hire talented individuals who are conscientious, dedicated, customer focused, and able to build lasting relationships and are committed to fostering a welcoming culture, offering opportunities for meaningful work and professional growth.
Deliver world-class service to our clients by building customer relationships.
Investigate claims and drive fair, timely resolutions.
Focus on applying professional judgment to deliver the best possible claims experience.
Strala is an AI-native Third-Party Administrator (TPA) that focuses on P&C claims. They combine agentic AI with expert human oversight to deliver faster, more accurate, and fully transparent claims handling. The company is experiencing rapid growth and is backed by top-tier investors, fostering a collaborative team environment.