Claims Specialist

Position: Claims Specialist (Workers' Comp)

Location: Grand Rapids, MI

Schedule: M-F, 8:30am-5pm ET

Worksite Arrangement: In-office during training (~3months), Hybrid after training period

Starting Compensation: $32/hr

Start date: ASAP

About Avenica

Avenica is a career-launching platform that uses data science, behavioral psychology, and performance coaching to unleash human potential and launch careers. By getting to know candidates beyond a resume and uncovering individual potential, we propel careers across the U.S. At Avenica, we put candidates first by advocating for them through the application and interview process. Learn more about Avenica and how we can support your job search at www.avenica.com .

Overview

Avenica is currently evaluating talent for a Claims Specialist in the insurance industry. This person will be responsible for handling workers' compensation claims for lost time, from initial filing to successfully closing the claims. Strong communication, customer service, and organization skills are critical for managing the daily tasks in this role. G reat opportunities for long-term career growth!

Responsibilities

• Conducts ongoing investigations for claims resolution, obtaining facts and taking statements as necessary, with insured, claimant and medical providers.
• Files workers’ compensation forms and other data with states to ensure compliance with regulations.
• Informs insureds, claimants and attorneys of claim denials when applicable.
• Timely administration of medical and indemnity benefits throughout each claims case, as required.
• Prepares reports on investigation, settlements, denials, and evaluations of the parties involved.
  
  

Requirements

• Minimum of high school diploma or equivalent required
• 2+ years of previous claims and insurance experience required in: medical claims, personal injury, general liability, or related paralegal experience.
• Strong analytical skills for claims and data analysis
• Exceptional time management and multi-tasking skills to consistently meet deadlines
• Must be legally authorized to work in the US, Avenica is not able to provide sponsorship at this time
• Ability to learn new systems quickly
• Billing experience or medical terminology knowledge preferred
• This role does require obtaining Claims Adjuster licensing-cost for first take of the exam will be supported by the company!
  
  

Avenica is committed to providing equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law.

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