Claims Assistant

Job Description The Claims Assistant II supports the claims adjusting team in the workers’ compensation department. The role involves record maintenance, data entry, and administrative support to ensure efficient claims processing and high-quality service. Essential Functions Organize digital claim records for uniformity by removing duplicate records and top‑lining documents. Complete 10‑day and 6‑month claim maintenance checklists to ensure the highest level of claims statistical data processing and correct data errors as required. Execute manual Medicare queries of claims at the CMS COB&R site as needed and document the digital claim record. Process class code corrections that accurately depict the scope of an injured worker’s job and payroll. Complete claim documents in both ImageRight and Powersuite. Close, re‑open, and reassign claim files as submitted by supervisory personnel. Assist with record subpoenas and complete lien reviews with a worksheet summary. Submit vendor referrals by service specialty and utilization review submissions to Rising. Maintain contact with the WCAB for status updates on claims where named as a party to suit in error. Comply with Maximus responses following IMR for timely fulfillment. Review adjuster ImageRight tasks daily for medical authorization requests. Provide administrative assistance to claim adjusting team members as needed. Assist in the entry of manual payments to the Claims Payable Analyst. Other duties and projects as assigned. Competencies / Qualifications Professional telephone demeanor, good verbal and written communication skills, good listening skills, and strong organizational skills. Thorough knowledge of workers’ compensation claims procedures and policies. Strong understanding of human nature and motivation principles. Ability to handle problems in stressful, conflict‑laden situations. Computer literacy, strong familiarity with Microsoft Office Suite, and ability to type 45 WPM. Basic understanding of business technology. Responsive to changing business needs. Ability to work well under pressure and multi‑task in a fast‑paced environment while maintaining attention to detail. Adherence to the code of ethical conduct. Ability to take direction and make decisions. Quick learner, adaptable to changing environments. Team player who can work with limited supervision. Education / Experience Requirements High School Diploma or equivalent (minimum). College degree preferred. 1–2 years of relevant claims processing experience, preferably in workers’ compensation or related field. Desire for career development within the insurance industry. Work Environment This role operates in a clerical, office setting using standard office equipment such as computers, telephones, photocopiers, and fax machines. Pay Details The base compensation range for this position is $17 – $19 per hour. Placement within the range will be based on skills, experience, qualifications, location, and internal equity. Candidate Requirements The candidate should be comfortable with an on‑site presence to support collaboration, team leadership, and cross‑functional partnership. Employee Benefits Physical Wellness: Comprehensive medical, dental, and vision insurance; life and disability insurance; fertility benefits; wellness resources; and paid sick time. Mental Wellness: Generous paid time off and holidays; Employee Assistance Program; complimentary Calm app subscription. Financial Wellness: Immediate vesting in a 401(k) plan; Health Savings Account and Flexible Spending Account options; commuter benefits; and employee discount programs. Family Care: Paid maternity and paternity leave (including for adoptive parents); legal plan options; and pet insurance coverage. … and so much more! Equal Opportunity Employer Acrisure is an equal‑opportunity employer. We consider qualified applicants without regard to race, color, religion, sex, national origin, disability, or protected veteran status. Applicants may request reasonable accommodation by contacting View email address on click.appcast.io. Final candidates will be required to complete post‑offer verification processes in accordance with applicable laws. #J-18808-Ljbffr