Pinnacol Assurance

Pinnacol Assurance

Claims Representative II

Denver · Mid

Sponsorship not specified$67k-$72kDetected 5 days ago
Customer SupportCommunicationUnderwriting

About the role

  • And while we may be a little biased, we believe that our work shapes communities and changes lives.
  • We've been around for more than 100 years, but don't let that fool you.
  • Pinnacol is committed to taking care of Colorado employers and workers in the most innovative ways.

Responsibilities

  • Work with team members to strategically and proactively manage indemnity claims and claim-related issues to the most expedient, cost effective resolution
  • Work with team members to strategically and proactively manage indemnity claims and claim-related issues to the most expedient, cost effective resolution; provide quality customer service to all stakeholders which includes proactive communication and follow through at all times.
  • Perform other duties as assigned.
  • Be able to manage the relationships with your stakeholders in order to obtain timely and accurate information in order to complete this process.

Requirements

  • Determine compensability as required by Company best practices, case law and the Colorado Workers' Compensation Act.
  • Facilitate completion of settlement documents and obtain approval from the DOWC as required by Company best practices.
  • Inform policyholders and agents of claim status and significant development as required by Company best practices.
  • Must utilize knowledge of likely treatment and outcomes for a variety of injuries, as well as predict the cost of that treatment.
  • Process records as required by Company documented best practices.
  • Regular attendance required.
  • Attend marketing visits with agents and/or policyholders as required.
  • We love who you are.

Compensation

  • $66,500 - $71,800 USD

Benefits

  • Evaluate claims for settlement by determining most likely medical path and return to work possibilities.
  • May include estimation of indemnity benefits including permanent impairment.
  • Set and maintain current, accurate and adequate reserves by reviewing medical records and determining the likely future treatment for the specific injury and circumstances.
  • Evaluate medical bill referrals to determine relatedness to claim and appropriateness of the bill as required by Company documented best practices.
  • Read and analyze medical records in order to maintain a current and accurate understanding of a claims' medical progress.
  • A successful candidate will have 1 or more years of experience managing workers' compensation claims, with a proven proficiency in resolving medical claims.
  • Our benefits go beyond the basics.
  • You'll get to choose from diverse benefit offerings for medical, dental and vision.

This listing is sourced directly from Pinnacol Assurance's careers page and normalized into a canonical job model.