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AF Group Claims Payment Specialist I/II in Lansing, Michigan

SUMMARY: Claims Payment Specialist I Primarily responsible for all of the following duties Enterprise wide; Analysis and entry of detailed wage data into the claim system for up to five states, contact with employers to obtain missing wage information or to clarify information submitted for up to five states, issuance of non-indemnity and non-medical payments and manual payments, processing of refunds and transfers, handling route back checks for distribution. Researches and resolves returned non-medical checks. Contacts include agents, policyholders, claimants, attorneys, and other Claims Department staff. Claims Payment Specialist II Primarily responsible for all of the following duties Enterprise wide; Analysis and entry of detailed wage data into the claim system for more than five states, which includes manual states, determination of compensation rate for manual states, contact with employers to obtain missing wage information or to clarify information submitted for more than five states, issuance of non-indemnity and non-medical payments and manual payments, processing of refunds and transfers, handling route back checks for distribution, posting manual payments, processing refunds and transfers, research and resolution of returned non-medical checks. Contacts include agents, policyholders, injured workers, attorneys, and other Claims Department staff. PRIMARY RESPONSIBILITIES: * Analyze and enter detailed wage information into the claim system. * Review payment requests to ensure compliance with the Workers Compensation regulations. * Contact policyholder for wage clarification and to obtain necessary information. * Verifies, calculates, and pays approved injured worker travel and miscellaneous expenses. * Stops and voids payment checks as requested. * Sorts and distributes checks as requested. * Validates, investigates and completes refund and transfer documents. * Analyzes, Validates, Approves and Processes Attorney, Legal, IME, Vocational Rehabilitation, Medical Management and all other vendor invoices. * Contacts agents, policyholders, and injured workers to verify or gather claim information. * Prepares form letters and composes general correspondence. * Alerts Claim Handlers on reserve deficiencies. * Participates on projects as requested. Additional responsibilities of Claims Payment Specialist II: * Prepares form letters and composes general correspondence. * Assists Finance with EFT Process as requested. * Calculates Average Weekly Wage and Compensation Rate for states not programmed in the claim system. * Performs all duties under Claims Payment Specialist I for more than five states. * Files required initial and subsequent jurisdictional filings via EDI, paper, and State Websites. * Researches and resolves errors received from jurisdictional filings. * Works closely with claim handlers to ensure proper data is being transmitted to State Regulatory Offices. * Reports to State Regulatory Offices in a timely manner. * Maintains accurate records of State reports generated. Reconciles these records against State benchmark criteria. This description identifies the responsibilities typically associated with the performance of the job. The percentage of time in any responsibility may vary between positions. Other relevant essential functions may be required. EMPLOYMENT QUALIFICATIONS: EDUCATION REQUIRED: High School Diploma or G.E.D. Advanced training or college level coursework in business, accounting, or insurance. Combination of education and experience may be considered in lieu of additional training or coursework. EXPERIENCE REQUIRED: Claims Payment Specialist I Two years general office experience performing relevant duties that provides the necessary skills, knowledge and abilities. Claims Payment Specialist II Two years general office experience and one year as a Claims Payment Specialist I OR Three years general office experience including one year in an insurance organization with demonstrated technical

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