Southwest Key Programs Inc.

Claims Coordinator

US-TX-Austin
3 weeks ago
Job ID
2017-7718
# Positions
1

Job Summary:

The Claims Coordinator administers Southwest Key’s business claims program. This individual provides oversight in the review and processing of documents for all business claims and ensures compliance with relevant policies, procedures, regulations, and laws. The Claims Coordinator updates and advises injured employees, program management, and the risk department in the administration of claims.  

Essential Functions:

  • Review and process all work-related accident reports for completeness and accuracy.
  • Complete and submit claims documentation to carrier as requested or required.
  • Use claim management portal for the efficient management of claims.
  • Ensure claims processing complies with Southwest Key policies, procedures, and network requirements as well as relevant laws and regulations.
  • Monitor claims and proactively review and encourage files to closure.
  • Communicate and work with adjusters in the oversight of Southwest Key claims.
  • Report and alert leadership of large or catastrophic claims.
  • Review and monitor reserve alerts at designated threshold levels.
  • Maintain a working knowledge of workers compensation statutes for states in which Southwest Key operates.
  • Maintain and update clinic lists for the all Southwest Key locations.
  • Participate in telephonic and in-person claim reviews and accommodation meetings.
  • Assist with and monitor the return to work program for injured employees.
  • Interact with and provide guidance and updates to Southwest Key management and employees on claims status.
  • Create and conduct trainings, reference guides, cheat sheets and other tools for employee education.

Other Functions:

  • Provide efficient and professional customer service in the management of claims.
  • Able to react to change productively and handle other tasks as assigned.
  • Complete assigned projects in an efficient manner.
  • Regular and punctual attendance.

Qualifications and Requirements:

  • Bachelor's degree with one (1) year claims experience.
  • Associate’s degree with two (2) years of claims experience.
  • High school diploma or equivalent with five (5) years of claims experience. Adjuster’s license preferred.
  • Computer literate with working knowledge of Microsoft Windows (Microsoft Word, Excel) and a variety of online database systems, managing files and records, designing forms and other office procedures and terminology.
  • Strong reading comprehension, analytical and organization skills and abilities.
  • Regular and punctual attendance.
  • Bilingual English/Spanish preferred.

Physical Demands:

Must be able to read, write, and communicate both verbally and in written form to express and exchange ideas. While performing the responsibilities of this job, the employee must be able to access all components of their workstation and other office equipment. Frequent sitting, walking, typing, writing, bending and twisting. Must be able to lift up to 10 pounds.

Work Environment:

General office environment with moderate noise. This position is mostly sedentary, involves sitting most of the time, but will involve walking or standing for brief periods. A fluctuating environment with many unscheduled interruptions. Frequent computer use at workstation for extended periods. Travel 10%.

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