CLAIMS ADJUSTER, LOST TIME (474B) [235]
: Job Details :

Classified Job Number 240####### Start Date 11/01/2024 Open Date 10/21/2024 Closing Date 10/25/2024 POSITION TITLE: Claims Adjuster, Lost TimeJOB CODE: 474BDIVISION: Human ResourcesSALARY SCHEDULE: Office Clerical/Technician AnnualDEPARTMENT: Support ServicesWORK DAYS: Annual Administrative EmployeesREPORTS TO: Assistant Director, Risk ManagementPAY GRADE: Rank VII (NCT7)FLSA: Non-ExemptPAY FREQUENCY: MonthlyPRIMARY FUNCTION:Handles all activities on lost time claims which include claims investigation; calculates and issues all indemnity payments; reviews medical treatment plan submitted by medical providers; approves appropriate treatment; interacts frequently with injured workers and responds in a courteous manner; files all applicable forms with State Board of Workers Comp.REQUIREMENTS: 1.Educational Level: High School Diploma or GED required2.Certification/License Required: None3.Experience: 2 years of experience in claims processing4.Physical Activities: Routine physical activities that are required to fulfill job responsibilities5.Knowledge, Skills, & Abilities: Written and oral communication skills; computer technology; organization; critical analysis abilityThe Board of Education and the Superintendent may accept alternatives to some of the above requirements.ESSENTIAL DUTIES:1.Demonstrates prompt and regular attendance.2.Claims investigations; manages lost time workers compensation claims; interviews injured employee, employee supervisor and medical providers; submit to depositions; testifies and attends Worker's Comp hearings, as needed; ongoing interactions with defense and claimants attorneys. 3.Completes WC-1, WC-2, WC-3, and WC-4 and other State Board forms in a timely manner to provide to State Board via mail and electronic filing on the State Board EDI system. 4.Assesses treatment plans from medical providers; authorizes appropriate treatment, including scheduling IME's, FCE's, Physical therapy, Pharmacy and Home Health Care.5.Calculates indemnity payments based on 13 week salary history, maintains payment schedule and issues weekly benefit to injured workers. 6.Reviews medical bills for appropriateness of treatment; applies Georgia fee schedule to medical bills and approves for payment. 7.Works on vendor selection for medical services and products, including the Panel of Physicians; negotiates best pricing on durable medical equipment, diagnostics, Physical Therapy, Pharmacy and Home Health Care. 8.Obtains and maintains CWCP certification; attends continuing education seminars, conferences and webinars.9.Answers telephone and assists or routes calls to appropriate individuals; composes correspondence to attorneys, medical providers and claimants.10.Performs other duties as assigned by appropriate administrator.Shift Type Full-Time Shift Start 8:00 AM Shift End 4:00 PM Job Category Clerical