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Claims Payment Specialist in Lansing, MI at AF Group

Date Posted: 12/5/2018

Job Snapshot

Job Description

Responsible for all of the following duties Enterprise wide; Analysis and entry of detailed payment data into the claim system for all states including manual states, contact with employers to obtain missing payment information or to clarify information submitted, issuance of non-indemnity and non-medical payments and manual payments, processing of refunds and transfers, handling route back checks for distribution, posting manual payments, research and resolution of returned non-medical checks. Contacts include agents, policyholders, claimants, attorneys, and other Claims Department and Service Center staff.

PRIMARY RESPONSIBILITIES:

  • Review payment requests to ensure compliance with the Workers Compensation regulations.
  • Contact policyholder for payment clarification and to obtain necessary information.
  • Verifies, calculates, and pays approved injured worker travel and miscellaneous expenses.
  • Stops and voids payment checks as requested.
  • Sorts and distributes checks as requested.
  • Validates, investigates and completes refund and transfer documents.
  • Analyzes, validates, approves and processes attorney, legal, IME, vocational rehabilitation, medical management and all other vendor invoices.
  • Contacts agents, policyholders, and injured workers to verify or gather claim information.
  • Prepares form letters and composes general correspondence.
  • Alerts Claim Handlers on reserve deficiencies.
  • Participates on projects as requested.
  • Post Excess & TPA Payments to claim files.
  • Post internal claim costs.
  • Post manual payments.
  • Provides assistance as a Subject Matter Expert for procedures and workflow documentation.
  • Prepares form letters and composes general correspondence.

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