In accordance with state and federal workers' compensation laws and regulations, this role creates and maintains medical claim information and industrial medical reports using internal applications and systems. The position determines the correct employer, insurance carrier, and claim number for assignment to claim files and reports, obtains necessary information to complete reports, ensures correct assignment of industrial visits for billing and reporting, investigates potentially reportable industrial treatment, and prepares claim files and reports accordingly. It also communicates with employers, insurance carriers, and other permissible parties and ensures follow-up treatment is scheduled in accordance with the treatment plan.
The role supports industrial injury reporting, late discovery case handling, correspondence processing, claim documentation, and coordination with Revenue Cycle and other internal teams to support accurate billing and reporting.
- Minimum 2 years of experience in Occupational Health, Workers' Compensation, or insurance claims processing/adjudication/claims examination
- High school diploma or GED required
- Must pass testing in medical terminology, Microsoft Word, and Microsoft Excel
- Experience with electronic medical records and PC applications
- Strong verbal and written communication skills
- Customer-oriented
- Ability to work in a Labor/Management Partnership environment
- Ability to pass a 40 wpm typing test
- Preferred: knowledge of California workers' compensation law or claims process
- Preferred: familiarity with ICD diagnosis coding system
Location
California, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
3 weeks ago