Claims Assistant

Claims Assistant

Keenan, now a part of Gallagher, is seeking a detail-oriented and organized Claims Assistant to join our Workers' Compensation Claims team. In this role, you will be responsible for supporting our Claims Examiners in the administration and management of workers' compensation claims. You will play a critical part in delivering exceptional service to injured workers, clients, medical providers, and internal teams while ensuring claims are handled accurately and efficiently. As part of Gallagher, a global leader in insurance, risk management, and consulting, you'll be joining a team that's passionate about helping individuals and organizations thrive.

How you'll make an impact:

• Setting up and maintaining new claims files and entering claim data accurately.
• Processing indemnity payments, benefit calculations, and payment cycles.
• Requesting and reviewing wage statements and performing wage calculations.
• Monitoring claims to identify, prevent, and mitigate potential penalties.
• Conducting 3-point contact to verify injury details, compensability, and work status.
• Reviewing and processing Division of Workers' Compensation (DWC) notices, letters, and forms.
• Managing claim correspondence, including delay letters, statute letters, denial notices, and closing letters.
• Calculating and processing mileage reimbursements and related benefits.
• Verifying lost time, waiting periods, and return-to-work status.
• Assisting with modified duty and return-to-work programs.
• Maintaining diaries, claim notes, and electronic claim records.
• Identifying issues that may require escalation or conversion to indemnity claims.
• Coordinating medical appointments and processing Qualified Medical Evaluator (QME) referrals.
• Processing Independent Medical Review (IMR) requests and utilization review referrals.
• Preparing and serving legal documents, including Stipulations and Compromise & Release agreements.
• Reviewing mail, medical bills, and documentation daily to ensure timely processing and compliance.
• Investigating questionable claim circumstances and escalating concerns when appropriate.
• Collaborating with claims examiners, nurse case managers, medical providers, attorneys, and clients.
• Maintaining high levels of client and claimant satisfaction through responsive communication and service.

Compensation: The target salary range for this position is $45,000 to $55,000 (US Dollar) annually. The actual salary will vary based on applicant's education, experience, skills, and abilities, as well as internal equity and alignment with market data. The salary may also be adjusted based on applicant's geographic location.

About You Required: High school diploma or GED and a minimum of 1 year transferrable work experience within an office environment. Ability to pass any required licensing exams within three attempts. Excellent written, verbal and mathematic skills. Working knowledge of current PC software such as Word and Excel. Familiar with medical terminology. Preferred: Licensed for all states in which claims are being handled. One year relevant Worker's Compensation experience. Behaviors: Ability to operate in a team environment with the expectation of enhancing and contributing to the offices overall effectiveness and success. Able to maintain strict confidence regarding information contained in assigned work. Ability to professionally interact with all levels of branch personnel, as well as, clients, vendors and all other office visitors.