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