Berkshire Hathaway Homestate Companies - Workers Compensation Division · 14 hours ago
Claims Assistant 1
San Diego, California
Full-time
Onsite
New Grad, Entry Level
$22.60/hr - $22.60/hrBerkshire Hathaway Homestate Companies is a national insurance group with over 50 years in business, dedicated to delivering quality insurance products. They are seeking a Claims Assistant to support Claims Professionals in the administration of benefits for injured workers, ensuring compliance with regulations and timely communication of issues.
Financial ServicesInsurance
Responsibilities
Reviews and prioritizes daily diary instructions from Claims Professional and/or Supervisor, ensuring appropriate urgency is given to time sensitive tasks (e.g., payments, regulatory notices), and promptly notifying of any impediment to task completion
Communicates with Claims Professional and/or Supervisor to clarify and rectify discrepancies and/or obtain proper approval prior to completion
Accurately assesses benefit eligibility pursuant to State regulatory guidelines
Issues correlating payments and benefit notices timely, including amended notices when applicable
Issues compensability notices timely adhering to State regulatory guidelines and company protocols
Generates new claim set up notifications/correspondence for incoming claims and for those claims identified for transfer from the Medical Claims Specialist Unit to Indemnity Unit
Secures wage information needed timely upon identification of need for transfer
Assists with scheduling medical evaluations as needed
Routinely updates on disability status post-appointment
Appropriately schedules and manages use of vendors when necessary for transportation, translation, and subpoena services
Coordinates service of required documentation to appropriate parties on litigated claims: Prepares index of documentation
Assists with cover letter as necessary
Ensures appropriate documentation is included in package and any necessary redaction is completed
Verifies service completion
Timely submits necessary internal service requests with required documentation to appropriate department for handling: Check pull/voids, stale-dated, and stop payment requests
Reissuance of medical payment (Medical Bill Review)
Non-Medical Bill Review payment requests (legal billing and non-medical vendor requests)
Return-To-Work referrals
W-9 coordination for payment requests
Timely and concisely notes updates upon completion of tasks within the Claims Tracking System
Appropriately escalates issues/red flags to Claims Professional and/or Supervisor
Completes other ancillary services as needed, including coverage of Reception desk
Qualification
Required
High School Diploma or HS Equivalency credential required
Ability to read and interpret documents such as medical reports, legal documentation (settlement documentation), and State regulatory guidelines governing workers compensation
Ability to write routine correspondence
Knowledge of Microsoft Office 365 applications (e.g., Word, Excel) and be proficient on applicable databases, systems, and vendor software programs
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals
Ability to compute rate, ratio, and percent and to draw and interpret bar graphs
Time Management/Sense of Urgency
Attention to detail
Service oriented
Able to manage multiple priorities effectively
Sound communicator
Excels in the spirit of collaboration
Benefits
Modern Office Setting
Free On-Site Fitness Facility
Free On-Site Garage Parking
Paid Time Off
Paid Holidays
Immediate Vesting of Retirement Savings + Company Match
Group Health Insurance (Medical, Dental, and Vision)
Life and AD&D Insurance
Long Term Disability Insurance
Hospital Indemnity Insurance
Accident and Critical Illness Insurance
Flexible Savings Accounts
Paid Community Volunteer Day
Employee Assistance Program
Tuition Reimbursement Program
Employee Referral Program
Diversity, Equity and Inclusion Program
Company
Berkshire Hathaway Homestate Companies - Workers Compensation Division
Financial Strength and Integrity With more than 50 years in business, BHHC has grown from a regional organization to a national insurance group, offering insurance products from coast to coast.
Founded in 1970
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
A
Andy Linkhart
Chief Claims Officer and Chief Financial Officer
David Speights
Vice President of Analytics
Recent News
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