Medical Only Occupational Accident Claims Adjuster, Work Comp Paralegal, Legal Assistant

This is a fully remote position, open to applicants in Arizona.

📋 Description

• Conduct investigations and make adjustments on occupational accident claims following established claims handling protocols, adhering to Blue Star guidelines and supervision.

• Analyze medical, legal, and miscellaneous invoices to assess their reasonableness and relevance to ongoing occupational accident claims.

• Authorize and process payments for occupational accident claims, adhering to our claim processing procedures in line with policy language and within designated authority limits.

• Manage and process medically necessary and relevant bills in accordance with policy provisions.

• Make timely claim decisions that are well-supported and informed.

• Anticipate potential exposure for reserving claims.

• Maintain ongoing communication with policyholders.

• Negotiate settlements when appropriate, in accordance with policy terms and within authority levels.

• Provide high-quality claims service to clients and respond promptly to their needs.

• Acquaint yourself with jurisdictional challenges and remain aware of potential exposure risks.

• Efficiently manage your time and apply meticulous attention to detail for each claim you handle.

• Utilize established forms and adapt letters following policy provisions.

• Review and document medical records, detailing treatment plans, restrictions, and proposed actions.

• Distinguish between mechanisms of injury, symptoms, and unrelated conditions.

• Administer policy benefits in accordance with policy terms.

• Drive claims toward optimal resolution, ensuring payment aligns with the policies we administer.

• Build valuable relationships with our Insureds, Motor Carriers, Brokers, Providers, and Preferred Vendors.

• Collaborate effectively as a team player.

• Exhibit flexibility, take initiative, and work with minimal direct supervision.

• Exercise discretion and maintain confidentiality as required.

• Communicate clearly, both verbally and in writing, with internal and external stakeholders.

• Stay organized, be a self-starter, and prioritize tasks with a keen attention to detail.

• Perform additional duties as assigned.

⛳️ Requirements

• High school diploma or equivalent.

• Minimum of two years of experience in medical claims, claims adjusting, paralegal work, or as a legal assistant.

• Proficiency in Microsoft Office.

• Successful completion of our pre-employment assessment via the link provided below.

🏝️ Benefits

• Competitive salary with potential performance-based bonuses.

• Comprehensive medical, dental, and vision insurance.

• 401(k) plan with company matching contributions.

• Paid time off and holidays.

• Opportunities for professional development.