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Claims Associate - Workers Compensation

PMA Companies Irving Full-Time
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As a member of our Claims team, you will proactively manage medical only and limited lost time claims in order to minimize losses, manage permanent total claims in order to minimize losses, and provide superior customer service.

Responsibilities:

  • Contact accounts on First Notices of Loss to obtain missing information pertinent to file set-up
  • Process payments, answer phone calls, authorize treatment associated with Medical Only claims
  • Complete appropriate contacts within 24 hours of assignment, and establish and maintain appropriate diary for follow-up
  • Determine whether treatment is appropriate and causally related to the compensable injury
  • Redirect treatment to network physicians as appropriate
  • Refer subrogation potential claims or potential permanency claims to Supervisor
  • Work to ensure compliance with all appropriate jurisdictional requirements on Medical Only claims, including timely form filing if applicable
  • Maintain a working knowledge of jurisdictional requirements and obtain/maintain state adjusting licenses
  • Administer benefits on Permanent Total or Death cases, which includes monitoring for changes in life or work status, implied interest in resolution or marked increases in costs.
  • Demonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.
  • High school diploma or equivalent
  • One or more years of Workers Compensation claims handling experience
  • Active TX adjusters license or ability to obtain
  • Familiarity with medical terminology
  • Ability to work independently, handle multiple tasks simultaneously, make difficult decisions and focus on details
  • Strong organizational skills
  • Excellent verbal and written communication skills
  • Proficiency MS Excel and MS Word.

Recommended skills

Coordinating
Subrogation
Self Motivation
Stress Management
Verbal Communication
Written Communication
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Job ID: 2347

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PMA Companies has nearly a century of successful business experience. Today, PMA Companies is a member of Old Republic Companies. Old Republic is among the nation's 50 largest publicly held insurance organizations, with a substantial interest in major segments of the industry. Old Republic is primarily a commercial lines underwriter, serving many of America's leading industrial and financial services companies as valued customers.

Since 1923, Old Republic has grown as a specialty insurance business, though its oldest subsidiary has insured lives since 1887. Old Republic's record as a long-term growth company is one of the best in the industry. Its performance reflects an entrepreneurial spirit, sound forward planning and a corporate structure that promotes and encourages assumption of prudent business risks.

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