Claims Assistant
Zenith Insurance Company is a team of Workers' Compensation Specialists committed to helping businesses succeed. The Claims Assistant role involves performing diverse clerical duties, assisting examiners with caseload management, and ensuring compliance with medical management protocols.
Responsibilities
- Responsible for assisting examiners and management of assigned caseload by performing clerical functions according to the Zenith timeframes and guidelines
- Performs detailed telephone investigations and maintains disability status checks with physicians and policyholders as directed by examiner
- Arranges medical examinations; may send physician cover letter with assistance or approval of examiner, and compose routine narrative memorandums and letters as directed by examiner
- Prepares and types legal documents; Answers, Declaration of Readiness to Proceed, Compromise and Release, and other related forms and memorandums
- Makes disability and medical payments within given authority
- Inputs and monitors automatic disability schedule payments and cancellations
- Timely management of assigned tasks by systems diary
- Proficient use of computer to include Claims information, coverage, DWC notices and payment verification
- Word, Outlook Calendar, E-Mail, Performa, and Zeus knowledge required
- Calculate wage statements and make appropriate adjustments in the system
- Understands and complies with medical management protocols and standards
- May assume back-up in absence of examiner
- Assists in training of Claims assistants and other clerical personnel
- Works productively and harmoniously with others on a consistence basis
- Respond positively to direction and criticism of performance
- Consistently maintain professional and appropriate demeanor
- Perform other duties as assigned
Skills
- High School Diploma or equivalent required
- Strong verbal and written communication skills with emphasis on telephone communication required
- Strong math and reading skills required
- Meets all state regulatory standards regarding licensing, continuing education, and other requirements
- Strong skills in time management, organization, and problem solving required
- Prior Workers' Compensation Claims assistant experience preferred
- Basic technical workers' compensation Claims knowledge preferred
- Bilingual skills preferred
Benefits
- Medical, Dental and Vision Insurance
- Flexible Spending Accounts
- Paid Parental Leave
- Life, AD&D and Disability Insurance
- 401(k), Employee Share Purchase Plan (ESPP)
- Education and Training Reimbursement
- Paid Leave: 3 weeks/year Vacation, 2 weeks/year Sick Leave
- 10 paid Company Holidays, 2 Personal Days, 2 Floating Holidays
- Employee Assistance Program (EAP)
Company Overview