Job Information
Maxim Healthcare Services Workers' Compensation Claims Examiner II in Columbia, Maryland
The Workers’ Compensation (WC) Claims Examiner II understands and participates in every aspect of the WC claim process. Working in a team approach, the WC Examiner II will make decisions concerning reserve adjustments, develop a plan of action, and determine the appropriate settlement value. The WC Claims Examiner II also works with the In-take Coordinators, the broker of record, the WC Manager and fellow Maxim co-workers at every level of the business.
Essential Duties and Responsibilities:
Manages and resolves new, pending, and litigated workers compensation files
Participates in and leads conference calls with local offices, third-party administrators (TPAs), medical providers, attorneys, and other Maxim team members
Monitors TPA’s file resolution plans
Ensure legal deadlines are met
Represents Maxim in depositions, mediation, and conference calls regarding assigned claim files
Provides, reviews and comments on the financial aspects of assigned claims files
Educate branch offices about all aspects of Workers’ Compensation
Provides excellent customer service to injured employees
Guides and advises Intake Coordinators and handles work overflow when necessary
Prepares WC claim reports for review by department management team
Reviews, identifies and make recommendations for maintaining control and/or reducing the claims experience (loss history) of the company
Assists Manager in achieving overall department goals
Performs other duties as assigned/necessary
Minimum Requirements:
College degree preferred; or equivalent work experience
One to Three years of Workers’ Compensation experience preferred
Some legal experience strongly preferred
Good organizational skills and attention to detail
Ability to work independently and cooperatively in a team environment
Ability to communicate effectively and provide excellent customer service with individuals at all levels of the organization
Computer proficiency, including Microsoft Office applications, required
Prior experience performing internet research
Ability to effectively elicit/provide information to and from appropriate individuals (including, but not limited to, supervisors, co-workers, clients) via strong communication skills; proficiency in the English language may be required
Flexible work hours such that over time can be worked if needed
About Maxim Healthcare Services
Maxim Healthcare Services has been making a difference in the lives of our patients, caregivers, employees and communities for more than 30 years. We offer private duty nursing, skilled nursing, physical rehabilitation, companion care, respite care and behavioral care for individuals with chronic and acute illnesses and disabilities. Our commitment to quality customer service, compassionate patient care, and filling critical healthcare needs makes us a trusted partner wherever care is needed.
Maxim Healthcare Services is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.
Maxim Healthcare Services
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