|Review medical records and approve appropriate treatment.|
|Investigate medical only claims to determine compensability in accordance with applicable statute, case law and experience.|
|Establish and maintain reserves appropriate for the anticipated claim costs.|
|Communicate with outside attorneys to resolve areas of dispute and negotiate appropriate and timely settlements.|
|Coordinate Independent Medical Exams (IME).|
|Provide quality customer service, an understanding of the claims process, and project positive corporate image.|
|Maintain accurate and detailed notepad documentation.|
|Prepare timely and appropriate file reviews as requested.|
|Utilize staff resources to assist in efficiency of daily work.|
|Review expenses and prepare reimbursements to injured workers, policyholders and providers, in a timely manner.|
|Provide clerical support to examiners.|
|Provide telephone coverage.|
|Conduct compensability analysis; monitor and document medical treatment to track progression of injured workers recovery and ensure treatment is appropriate.|
Bachelors Degree and experience in a medical or insurance setting preferred.
|Strong organization skills and attention to detail|
|Effective communication skills, both written and oral|
|Understanding of workers compensation|
|Intermediate knowledge of Microsoft Word and Excel; advanced knowledge of Outlook|
|Ability to learn custom software programs.|
Contact Notes and Special Requests
Kentucky Employers' Mutual Insurance (KEMI), is the largest provider of workers' compensation insurance in Kentucky with over 23,000 policyholders.
Please apply online at www.kemi.com and refer to the Careers link.