Claims Assistant

Claims Assistant

At Gallagher, we help clients face risk with confidence because we believe that when businesses are protected, they're free to grow, lead, and innovate. You're not just improving clients' risk profiles, you're building trust. You're backed by our digital ecosystem : a client-centric suite of consulting tools making it easier for you to meet your clients where they want to be met. Advanced data and analytics providing a comprehensive overview of the risk landscape is at your fingertips. You'll find a culture grounded in teamwork, guided by integrity, and fueled by a shared commitment to do the right thing. We value curiosity, celebrate new ideas, and empower you to take ownership of your career while making a meaningful impact for the businesses we serve.

Keenan is a leading insurance brokerage and consulting firm serving hospitals, public agencies, and California school districts. Specializing in employee benefits, workers' compensation, loss control, financial services, and property & liability, Keenan is committed to delivering innovative solutions that protect and empower the communities we serve. As part of Gallagher, a global leader in insurance, risk management, and consulting, you'll be joining a team that's passionate about helping individuals and organizations thrive.

The Claims Assistant

The Claims Assistant is responsible for assisting Examiners in every aspect of claims administration. They will identify, prevent and mitigate potential penalties as well as deliver 3-point contact. This is a remote position located in California.

How you'll make an impact :

• Input data entry on all new claims.
• Provide indemnity payments and cycles.
• Request wage statements and wage statement calculations.
• Identify, prevent and mitigate potential penalties.
• Deliver 3-point contact (MO & / or Indemnity files) to verify the mechanics of the injury, compensability and discharge.
• Review all DWC letters (initial notices).
• Input form letters (30 day closing letters when appropriate).
• Calculate and pay mileage and benefits.
• Verify lost time and waiting periods.
• Review and manage modified duty.
• Perform maintenance of current diary.
• Input basic notes relating to claim, status and treatment.
• Identify issues requiring conversion to Indemnity to include supporting documentation.
• Refer all x-rays and diagnostic services to PRIME for utilization review.
• Process medical bills daily to avoid penalty and interest.
• Investigate all questionable claim circumstances and refer to the examiner when needed.
• Maintain 100% closing ratio.
• Return phone calls within 24 hours.
• Review mail / bills daily paperless system.
• Correct error report daily.
• Maintain client / claimant satisfaction.
• Perform indemnity payments and cycles.
• Request wage statement and wage statement calculations.
• Input all DWC (Division of workers' compensation) letters (notice, including denials).
• Process QME (Qualified medical evaluator) to receipt of report.
• Type Stipulations, mail to employee and WCAB (Worker's compensation appeals board).
• Type Compromise & Release and mail to the employee and WCAB.
• Schedule appropriate medical appointments, calculate mileage, and send appointment letters.
• File and serve appropriate documents.
• Complete investigation and copy service request forms.
• Refer all PRIME deletions to office designee only.
• Complete IMR (Independent Medical Review) and process in a timely and accurate manner.
• Maintain and update Work Status tab.
• Input statute letters, delay letters, or any other required initial letter.
• Interaction with nurse on case management regarding return-to-work status.
• Other duties as assigned.

About You

Required : High school diploma or GED and a minimum of 1 year transferrable work experience within an office environment. Ability to pass any required licensing exams within three attempts. Excellent written, verbal and mathematic skills. Working knowledge of current PC software such as Word and Excel. Familiar with medical terminology. Preferred : Licensed for all states in which claims are being handled. One year relevant Worker's Compensation experience. Behaviors : Ability to operate in a team environment with the expectation of enhancing and contributing to the office's overall effectiveness and success. Able to maintain strict confidence regarding information contained in assigned work. Ability to professionally interact with all levels of branch personnel, as well as, clients, vendors and all other office visitors.

Compensation and Benefits

We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market / geography, complexity or scope, specialized skill set, lines of business / practice area, supply / demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits. Below are the minimum core benefits you'll get, depending on your job level these benefits may improve : Medical / dental / vision plans, which start from day one! Life and accident insurance 401(K) and Roth options Tax-advantaged accounts (HSA, FSA) Educational expense reimbursement Paid parental leave Other benefits include : Digital mental health services (Talkspace) Flexible work hours (availability varies by office and job function) Training programs Gallagher Thrive program elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing Charitable matching gift program And more...

We Value Inclusion and Diversity

Inclusion and diversity (I&D) is a core part of our business, and it's embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work. Gallagher embraces our employees' diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest. Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as "protected characteristics") by applicable federal, state, or local laws. Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.