Cynet Systems

Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.. Develops and manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments.. Manages subrogation of claims and negotiates settlements.. May process complex lifetime medical and defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.. Working knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social.

workers compensation

Job Description: Pay Range $43hr - $48hr Responsibilities: <ul><li>Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency. </li><li>Develops and manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments. </li><li>Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract. </li><li>Manages subrogation of claims and negotiates settlements. </li><li>Communicates claim action with claimant and client. </li><li>Ensures claim files are properly documented and claims coding is correct. </li><li>May process complex lifetime medical and defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review. </li><li>Maintains professional client relationships. </li></ul> Qualification: <ul><li>Education & Licensing. </li><li>Bachelor's degree from an accredited college or university preferred. </li></ul> Experience: <ul><li>4 years of claims management experience or equivalent combination of education and experience required. </li></ul> Skills and Knowledge: <ul><li>Working knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social. </li><li>Security and Medicare application procedure as applicable to line of business. </li><li>Excellent oral and written communication, including presentation skills PC literate, including Microsoft Office products. </li><li>Analytical and interpretive skills. </li><li>Strong organizational skill Good interpersonal skills. </li><li>Excellent negotiation skills. </li><li>Ability to work in a team environment Ability to meet or exceed Service Expectations.</li></ul>

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