Claims Administrator

Position Summary:

The Claims Administrator is responsible for the day-to-day administration and handling of primarily medical-only claims, investigation, coordination with safety team, adjusters, making claim reports to the insurance / TPA, closing completed claims and ensuring compliance with procedures and deadlines. 

Key Responsibilities:

• Investigate, evaluate, and manage medical only work injuries. 
• Coordinate with safety and other claims team members. 
• Open new claim with TPA 
• Inputting claim details into claims management software
• Communicate with injured workers, employers, and other stakeholders professionally.
• Review and respond to subpoenas. ( Record collection and pick up coordination).
• Respond to routine inquiries from injured workers, providers, and attorneys, escalating as needed.
• Data entry and maintenance of claim status updates, diary entries, and payment records
• Assist with generating claim reports and spreadsheets.
• Provide general office support to the claims team (supplies, meeting coordination, correspondence)
• Mail Distribution and Collection. 

Qualifications:

Claims or administrative experience. (Entry/admin level: 0-2 years, prior general office experience)

Strong organizational skills and ability to manage volume claims communication. 

Excellent written and verbal communication skills

Helpful if candidate has knowledge of Claims, WCAB, Labor Code and best practices but not required. 

CitiStaff Solutions, Inc.