CRAWFORD & CO Medical Claim Analyst in GREAT FALLS, Montana

MEDICAL CLAIM ANALYST Requisition ID 2017-1696 Job Locations US-MT-Great Falls Posted Date 7/11/2017 Category Claims Business Unit Company MORE INFORMATION ABOUT THIS JOB EXCELLENCE IN EVERYTHING WE TOUCH POSITION SUMMARY Under direct supervision, processes medical only claims within authority, processes other claims open only for the administration of medical benefits i.e. maintenance claims without actuarial reserves; approves payments and claimant reimbursements on lost time disability claims, within authority, after compensability has been determined. RESPONSIBILITIES * Processes \\"M\\" Case claims medical only within area of payment authority up to, but not exceeding $3,500. * Processes claims, other than M cases, where all issues indemnity, legal, etc. have been settled and the claim is only open for payment of medical benefits i.e. maintenance claims not requiring actuarial reserves. * Contacts, by telephone, insureds, claimants, and medical providers for additional information or medical verifications to verify and report the status of claims. * May verify coverage on claims by following normal coverage confirmation procedures, as requested. Alerts Team Manager of any errors or discrepancies. * Reviews and updates data into a computerized system. * Approves payments of medical bills on lost time disability claims, within payment authority, after compensability has been determined by the Team Manager or claim technician/handler. * Informs Team Manager of all Workers Compensation \\"M\\" Case claims to be removed from the \\"M\\" Case classification per Claim Best Practice guidelines. * Answers routine questions, orally and in writing, from agents, claimants, insureds, or other interested parties. * Keeps Team Manager informed verbally and in writing of activities and problems within assigned area of responsibility; refers matters beyond limits of authority and expertise to Team Manager for direction. * Consults with other departments and business units. * Documents receipt and contents of medical reports. Reviews and handles other correspondence within authority including material from the team member, customer, or State. * Processes claims, other than M cases, where all medical issues have been settled and the claim is only open for payment of long term Indemnity benefits. * Identifies files that no longer meet the administrative criteria along with recommendation to team manager for reassignment. * With the team managers guidance, provides input on the completion of status reports, initiate s activity checks and/or widow s statement of dependency forms. * Strong benefits package including matching 401k; health, dental, and life insurance; employee stock purchase plans; tuition reimbursement and so much more. Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Company via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Company HR/Recruitment will be deemed the sole property of Company . No fee will be paid in the event the candidate is hired by Company as