Workers Compensation Claims Assistant I
asg claims administrationHouston (TX)
Workers Compensation Claims Assistant I
Posted 5 days ago
asg claims administrationHouston (TX)
SENIORITY
Mid
About the role
AvonRisk Claims Specialist AvonRisk is the nation's leading specialty risk manager for self-insured organizations, uniting respected regional leaders in workers' compensation, liability, managed care, and risk management across 32 states. With nearly 700 professionals and brands including Intercare, InterMed, George Hills, and AS&G Claims Administration, we're a people-focused, operations-driven organization that prioritizes reasonable caseloads, strong training, collaborative teams, and expert support. We invest in tools and workflows that reduce frictionnot increase volumeand create real career paths for professionals who want to grow their careers or move into leadership. At AvonRisk, you're part of a team that values good judgment, curiosity, and accountability, and gives you the support to succeed. Reports directly to the unit Claims Supervisor but takes primary direction for the assigned Claims Specialist(s). Responsible for providing clerical operations support to assigned Claims Specialist(s).
Essential Duties and Responsibilities:
- Prepares new claims files
- Calculates TTD, Wage Loss, VRMA and PD benefits
- Issues compensation payments on diary schedule
- Issues Benefit Notices
- Doctor status calls and Employee/Employer contact calls
- Employer contact calls to confirm light duty/modifies work
- Works closely with Claims Specialist to complete clerical assignments
- Prepares litigation documents such as C&R, Stipulations, Answers, etc
- Prepares rehabilitation forms for filing with the rehabilitation unit
- Handle calls from providers inquiring about unpaid bills and bill related questions
- Review Mail and process direct pays bills such as Mileage Reimbursement
- File and Serve duties (as needed)
- Notepad documentation in PortalSet up income benefit check schedules under the close supervision of the handling adjuster
- Mail claim documents and checks in a timely manner
- Draft template letters (Plain Language Notices) to support the adjusting team
- Document incoming medical records
- Set notifications of document receipt to adjusters from within the Risk Management Information SystemOther clerical functions, as assigned
Requirements: Competency:
- To perform the job successfully, an individual should demonstrate the following competencies:
- Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations.
- Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
- Team Work - Supports everyone's efforts to succeed.
Qualification Requirements:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience: High school diploma or general education degree (GED); or 1-2 years related experience and/or training; or equivalent combination of education and experience.
Salary Range:
The salary range listed is an estimate. Actual compensation will be determined based on several factors such as a candidate's experience, qualifications, skill set, and work location.
Benefits:
We take care of our people so they can take care of their work and their teams. AvonRisk offers a competitive, people first benefits package designed to support your health, financial security, and career growth, including:
- Comprehensive medical, dental, and vision benefits
- Company contributions to HSA and FSA plans
- Employer paid life and disability insurance 401(k) with company match
- Paid time off (PTO) and company paid holidays
- Learning and development opportunities that support real career advancement
- Employee assistance resources and a supportive culture that values balance and wellbeing
We're an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.
Pursuant to the Los Angeles and San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest or conviction records.
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