"You work for NJM? That's a great company!" If you're hired at NJM, you'll hear it over and over again from friends, family and neighbors. Why? Because NJM is committed to providing its customers with superior service, and great service goes a long way. Why else is NJM called a great company? Because our employees enjoy working here, are appreciated, and are provided with a terrific benefits plan. Employees who are hired at NJM often stay at NJM – many for the duration of their careers.

Our Workers’ Compensation Claims Team is seeking two Workers’ Compensation Claims Representatives, Level I. This is a full-time position and offers a hybrid schedule after training, working from home 3 days per week.

This role can be based in any of our three New Jersey office locations: West Trenton, Hammonton or Parsippany.

Responsibilities
Reporting to the Workers’ Compensation Claims Supervisor, the Workers’ Compensation Claims Representative I (CR 1) is responsible for preparing a complete and thorough investigation on assigned claims that ultimately leads to a compensability decision and a course of action to manage the claim. The incumbent will be responsible for contacting all parties involved in the claim, gathering and securing all necessary information to effectively evaluate the claim, summarize findings and provide an action plan to manage the claim. The CR 1 is accountable for the claim results of all assigned claims.

The position will work with and communicate to NJM policyholders, injured workers, medical providers, the NJM Medical Utilization Department, the NJM Special Investigation Unit, WC Legal Staff, and other departments within NJM, as needed.

The position will work under the direction of the Claims Supervisor in communicating with NJM policyholders, injured workers, medical providers, the WC Medical Services Administration department, the NJM Special Investigation Unit, WC Legal Staff, and other departments within NJM.

To accomplish this, the Workers’ Compensation Claims Representative I:

• Reviews, investigates and analyzes loss events, injuries and coverages to make a compensability decision and plan a course of action with the supervisor.
• Provides excellent communication with policyholders, injured workers, medical providers, brokers, and attorneys during the course of the claim.
• Manages all assigned claims, which includes, authorizing and monitoring appropriate medical treatment, responding to all inquiries, updating the policyholder on claim status, maintaining contact with the injured worker and documenting all actions taken throughout the course of the claim on all claims assigned to them.
• Under the direction of the Claims Supervisor, issues indemnity payments, and discusses all other events relevant to claims assigned to them.
• Partners with a mentor or Claims Supervisor on visits to policyholders, if needed.
• Assists in preparing and attends Claims Reviews in partnership with Claim Supervisor
• Utilizes NJM resources and coordinate with other NJM departments, including, but not limited to, WC Medical Services Administration, WC Sales, WC Underwriting, WC SIU, Legal, to bring special skills to the claim as needed.
• Complies with, and conducts all activities within, state WC claims laws and fair practices, NJM’s Code of Ethics, and NJM’s Best Practices and Policies.

Requirements

• 0-3 year’s work experience as a Claim Representative, or comparable insurance knowledge and experience with various aspects of claims handling and /or process.
• Excellent verbal and written communication skills.
• Professional telephone skills/etiquette.
• Strong interpersonal skills.
• Ability to work in a team and independently.
• Valid driver’s license and vehicle.
• Strong organizational skills and multi-tasking abilities
• Skilled at solving problems.
• Ability to make decisions based on organizational experience / knowledgebase.
• Experience with the Microsoft Office.
• High School Diploma or GED equivalent.
• Some travel.

Preferred:

• College degree
• Knowledge of Workers’ Compensation claims
• Bilingual abilities preferred (verbal and/or written)
• Experience utilizing an automated claim processing system.
• Medical terminology knowledge.

Schedule: Monday-Friday, specific hours are subject to selected start time between 8:00am-8:45am pending supervisory approval.

Salary Range: $47,000 - $54,000. Salary is commensurate with experience and credentials.

Legal Disclaimer: NJM is proud to be an equal opportunity employer. NJM is proud to be an equal opportunity employer. We are committed to attracting, retaining and promoting a diverse and inclusive workforce that is fully representative of the diversity that exists in the communities in which we do business.

Job Type: Full-time

Pay: $47,000.00 - $54,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Tuition reimbursement

Schedule:

• Monday to Friday

Work Location: Hybrid remote in Parsippany, NJ 07054

Please Note :
blog.nvalabs.org is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, blog.nvalabs.org provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.