Description
Company Overview:
Dollar General Corporation has been delivering value to shoppers for more than 80 years. Dollar General helps shoppers Save time. Save money. Every day.® by offering products that are frequently used and replenished, such as food, snacks, health and beauty aids, cleaning supplies, basic apparel, housewares and seasonal items at everyday low prices in convenient neighborhood locations. Dollar General operates more than 18,000 stores in 47 states, and we're still growing. Learn more about Dollar General at www.dollargeneral.com.
Job Details:General Summary:
Support the claims process by managing a high volume of work comp claims through claim closure. Manage light duty report including Leave Department communication, acting as a liaison between adjusters and Leave Dept. Assist with state electronic reporting and audits. Manage Legal and Medical billing queues for final billing and file closure, resolving any issues for open for bill claims.
Monitor a large number of open claims ensuring the final bills are paid and the claims are closed.
- Monitor and review the medical bill review website providing approval/denial of invoices.
- Diary each claim appropriately to insure all final invoices are paid.
- Follow up with claimants/doctor offices/adjusters/etc. on any open bill issues.
- Direct claims back to principal adjuster when action other than final bill payment is required.
- Complete any state reporting(paper or EDI) required with file closure
- Confirm that there is no outstanding authorization for light duty, and that Leave communication is complete before file closure
- Review and follow up regarding receipt of settlement documentation, general release, and final paperwork to complete closure and complete Leave communication.
- Provide support to team to obtain wage information and calculate average weekly wage and TTD rates, gathering of medical documentation, coordination with in-house nurse to assist with support for IME and IME scheduling.
- Support team with follow up calls regarding return to work or light duty documentation.
Assist with TPA (Third Party Administrator) requests for information
- Provide needed information to the TPA as requested.
- Obtain wage information, run wage statements, and communicate with Leave,
Manage the department's light duty report.
- Partner with the adjusters and the payroll department in determining if our employees should be receiving light duty pay.
- Work with adjusters and managers to reconcile a weekly light duty report insuring every person on the report should be receiving light duty pay.
- Obtain documentation at adjuster's direction to support light duty authorization
- Assist with Light Duty audit requests
- Manage the light duty reporting out of claim system and communicate results to involved parties ensuring proper allocation.
Assist with state audits, and state EDI reporting 5%
- Partner with the WC Managers and adjusters on multiple audits though out the year.
- Pull claim file information in preparation of audit
- Partner with adjusters and managers for state reporting requirements and EDI reporting
- Manage state reporting requirements via report to insure state filing requirements.
Assist with subpoena requests
- Assist managers and adjusters with subpoena requests
- Manage legal queue, indexing, resolving and appropriately escalating incoming requests
Knowledge and Skills:
- General Knowledge of workers' compensation claims processes.
- Possess the ability to multi-task.
- Must be highly organized and self-motivated.
- Possess the ability to perform duties with limited supervision.
- Must pay attention to detail and be able to prioritize.
- Should be an excellent communicator (written and oral)
- Should possess knowledge of Microsoft Office (Word, Excel, and Outlook)
- Must have excellent phone skills.
- Must be able to work in a team environment
Work Experience and/or Education:
College degree preferred but not required
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