WC Claims Support Representative

NJM Insurance Group has a WC Claims Support Representative position available in their West Trenton, NJ location.

The WCC Claims Support Department is responsible for a variety of support tasks stemming from the Claims and Legal Departments and State Agencies. The Support staff ensure benefits are accurate and processed in a timely manner. Benefits are reconciled to ensure the payee is receiving what they are entitled to according to State Statutes. The team processes stop payments or voids if the payee has not received or is not entitled to a payment. Also set up payees for electronic payments.

Claims support staff are responsible for coordinating with various stakeholders and agencies regarding Child Support Garnishments, annual reviews for Total Disability and Dependency claims to ensure eligibility of continued benefits accounting for potential changes that could impact payments. Mandatory Medicare reporting and related correspondence is processed, either accepting or disputing charges submitted for potential claim related treatment. Claims Support is also responsible for Electronic Data Management ensuring that efficient and appropriate storage of imaged documents in OnBase that are received by the Claims and Legal Teams.

Schedule: Monday to Friday (8:00AM- 4:15PM)

Hybrid: 3 days in office, 2 days remote once training is complete

Salary: $44,672 to $51,800 (Salary is commensurate with credentials and experience)

Job Responsibilities

• Confirm proper mathematical calculations are reflected on court orders and notices.
• Reconcile payments to ensure the appropriate financial updates can be completed.
• Updating claim center fields so that payments can be issued and to explain how payments are being made.
• Communicate with Claim Reps and Staff Attorney’s to ensure payments are made in accordance with State guidelines and statutes.
• Communicate with Injured Workers, Attorneys, Providers to obtain information for proper payments to be made.
• Create or complete letter templates.
• Review incoming documents for completeness and use the information to determine eligibility according to State Statutes.
• Complete assigned claim center activities in a timely and accurate fashion.
• Submit appropriate documents through Workday to ensure payments are issued correctly.
• Activities related to Medicare, Garnishments and EDM as needed
• Other activities assigned by Supervisor
  
  

Qualifications And Experience

• Good organizational and time management skills being able to multi task
• Detail Oriented with good analytical and math skills
• Good communication skills, verbal and written
• Critical thinking skills, being able to make sound decisions
• Ability to work with a team and independently
• Open and accepting to change
• Some knowledge of Workers Compensation
• High School required; Associates/ Bachelors preferred
  
  

Benefits Offered

• Medical Insurance (Blue Cross Blue Shield)
• Dental Insurance (Delta Dental)
• Vision (Delta Vision/ VSP)
• Flexible Spending Account
• Discounts on NJM auto insurance
• Tuition reimbursement
• Life insurance
• Plus, additional company discounts for items like travel, service, car rental and more!
  
  

Legal Disclaimer: NJM is proud to be an equal opportunity employer. We are committed to attracting, retaining and promoting a diverse and inclusive workforce that is fully representative of the diversity that exists in the communities in which we do business.