Description


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.

 

Requirements


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.

 

Contact Information


Contact Email: rprater@kemi.com
Contact Phone: Human Resources
Contact Website: www.kemi.com/careers

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PIA of Kentucky
107 Consumer Lane
Frankfort, KY 40601

Phone: 502-875-3888
Fax: 502-227-0839

Email:Click Here to Email Us

 

 
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