Athens Administrators
Athens Administrators provided pay range
This range is provided by Athens Administrators. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.
Base pay range $28.00/hr - $31.00/hr
ATHENS POSITION DETAILS
Position Title:
Assistant Claims Examiner - Flex
Department:
Workers’ Compensation
Reports To:
Claims Supervisor
FLSA Status:
Non-Exempt
Job Grade:
6
Career Ladder:
Next step in progression could include Future Medical Examiner or Claims Examiner Trainee
ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. We foster an environment where employees not only thrive but consistently recognize Athens as a “Best Place to Work.” Immerse yourself in our engaging, supportive, and inclusive culture, offering opportunities for continuous professional growth. Join our nationwide family‑owned company in Workers' Compensation, Property & Casualty, Program Business, and Managed Care. Embrace a change and come make an impact with the Athens Administrators family today!
Position Summary Athens Administrators has an immediate need for an experienced Assistant Claims Examiner - Flex to support our Workers’ Compensation department and can be located anywhere in the state of California. Employees who live less than 26 miles from the Concord, CA or Orange, CA offices are required to work once a week in the office on a day determined by their supervisor between Tuesday – Thursday. The remaining days can be worked remotely if technical requirements are met, and the employee resides in California. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday-Friday at 37.5 hours a week with the option of a flex schedule.
The Assistant Claims Examiner - Flex will provide clerical and technical assistance to Senior Claims Examiners and administer Medical Only claims, ensuring timely processing of claims and payment of benefits, managing and directing medical treatment, and setting reserves for a variety of teams and clients at Athens.
Primary Responsibilities
Process new claims in compliance with client’s Service Agreement
Issue all indemnity payments and awards on time
Process all approved provider bills timely
Prepare objection letters to providers for medical bills; delayed, denied, lacking reports.
Answer questions over the phone from medical providers regarding bills
Contact treating physician for disability status
Contact employer for return-to-work status or availability of modified work.
Contact injured worker at initial set up
Send DWC notices timely
Issue SJDB Notices timely
Request Job Description from Employer
Handle Medical Only claim files
Calculate wage statements and adjust disability rates as required
Keep diary for all delay dates and indemnity payments
Documents file activity on computer
Update information on computer, i.e., address changes, etc.
Schedule appointments for AME, QME evaluations
Send appointment letters, issue TD/mileage, send medical file
Schedule interpreter for appointments, depositions, etc.
Request Employer’s Report, DWC-1, Doctor’s First Report if needed
Verify mileage and dates of treatment for reimbursement to claimant
Subpoena records
File and serve documents on attorneys, WCAB, doctors
Serve PTP’s with medical file and Duties of Treating Physician (9785)
Request PD ratings from DEU
Draft Stipulated Awards and C&R’s
Submit C&R, Stipulated Awards to WCAB for approval with documentation
Process checks – stop payment, cancellations, void, journal payments
Handle telephone calls for examiner as needed
Complete penalty calculations and prepare penalty worksheets
Complete MPN, HCO and/or EDI coding
Complete referrals to investigators
Complete preparation of documents for overnight delivery
Work collaboratively with Senior Claims Examiners, Nurse Case Managers, and other Assistant Claims Examiners
Contact with clients, injured workers, attorneys, doctors, vendors, and other parties
Provide updates of claims status to Senior Claims Examiners and Athens management
Prepare professional, well written correspondence and other communications
Essential Position Requirements
High School Diploma or equivalent (GED) required for all positions
AA/AS or BA/BS preferred but not required
2+ years’ Claims Assistant experience supporting a workers compensation examiner or team preferred
Medical Only Adjuster designation required
Continuing hours must be current
Mathematical calculating skills
Completion of IEA or equivalent courses
Administrators Certificate from Self-Insurance Plans preferred
Knowledge of workers compensation laws, policies, and procedures
Understanding of medical and legal terminology
Must demonstrate accuracy and thoroughness in work product
Ability to sit for prolonged periods of time
Well-developed verbal and written communication skills with strong attention to detail
Excellent organizational skills and ability to multi-task
Ability to type quickly, accurately and for prolonged periods
Proficient in Microsoft Office Suite
Ability to learn additional computer programs
Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution
Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization
Seeks to include innovative strategies and methods to provide a high level of commitment to service and results
Ability to demonstrate care and concern for fellow team members and clients in a professional and friendly manner
Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor
Athens’ operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company.
Must be able to reliably commute to meetings and events as required by this position
APPLY WITH US We look forward to learning about YOU! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at http://www.athensadmin.com/careers/job-openings. Feel free to include a cover letter if you’d like to share any other details. All applications received are reviewed by our in-house Corporate Recruitment team. The Company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link: https://dcba.lacounty.gov/wp-content/uploads/2024/08/FCOE-Official-Notice-Eng-Final-8.30.2024.pdf
Equal Opportunity Statement Athens Administrators is an Equal Opportunity/ Assertive Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development.
Thank You We look forward to reviewing your information. We understand that applying for jobs may not be the most enjoyable task, so we genuinely appreciate the time you’ve dedicated. Don’t forget to check out our website at www.athensadmin.com as well as our LinkedIn, Glassdoor, and Facebook pages!
Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company-Paid STD & LTD and more! Further information about our comprehensive benefits package may be found on our website at https://www.athensadmin.com/careers/why-work-here
Seniority level Entry level
Employment type Full-time
Job function Finance and Sales
Industries Insurance
Referrals increase your chances of interviewing at Athens Administrators by 2x
California, United States
Get notified about new Claims Examiner jobs in
California, United States .
#J-18808-Ljbffr
Base pay range $28.00/hr - $31.00/hr
ATHENS POSITION DETAILS
Position Title:
Assistant Claims Examiner - Flex
Department:
Workers’ Compensation
Reports To:
Claims Supervisor
FLSA Status:
Non-Exempt
Job Grade:
6
Career Ladder:
Next step in progression could include Future Medical Examiner or Claims Examiner Trainee
ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. We foster an environment where employees not only thrive but consistently recognize Athens as a “Best Place to Work.” Immerse yourself in our engaging, supportive, and inclusive culture, offering opportunities for continuous professional growth. Join our nationwide family‑owned company in Workers' Compensation, Property & Casualty, Program Business, and Managed Care. Embrace a change and come make an impact with the Athens Administrators family today!
Position Summary Athens Administrators has an immediate need for an experienced Assistant Claims Examiner - Flex to support our Workers’ Compensation department and can be located anywhere in the state of California. Employees who live less than 26 miles from the Concord, CA or Orange, CA offices are required to work once a week in the office on a day determined by their supervisor between Tuesday – Thursday. The remaining days can be worked remotely if technical requirements are met, and the employee resides in California. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday-Friday at 37.5 hours a week with the option of a flex schedule.
The Assistant Claims Examiner - Flex will provide clerical and technical assistance to Senior Claims Examiners and administer Medical Only claims, ensuring timely processing of claims and payment of benefits, managing and directing medical treatment, and setting reserves for a variety of teams and clients at Athens.
Primary Responsibilities
Process new claims in compliance with client’s Service Agreement
Issue all indemnity payments and awards on time
Process all approved provider bills timely
Prepare objection letters to providers for medical bills; delayed, denied, lacking reports.
Answer questions over the phone from medical providers regarding bills
Contact treating physician for disability status
Contact employer for return-to-work status or availability of modified work.
Contact injured worker at initial set up
Send DWC notices timely
Issue SJDB Notices timely
Request Job Description from Employer
Handle Medical Only claim files
Calculate wage statements and adjust disability rates as required
Keep diary for all delay dates and indemnity payments
Documents file activity on computer
Update information on computer, i.e., address changes, etc.
Schedule appointments for AME, QME evaluations
Send appointment letters, issue TD/mileage, send medical file
Schedule interpreter for appointments, depositions, etc.
Request Employer’s Report, DWC-1, Doctor’s First Report if needed
Verify mileage and dates of treatment for reimbursement to claimant
Subpoena records
File and serve documents on attorneys, WCAB, doctors
Serve PTP’s with medical file and Duties of Treating Physician (9785)
Request PD ratings from DEU
Draft Stipulated Awards and C&R’s
Submit C&R, Stipulated Awards to WCAB for approval with documentation
Process checks – stop payment, cancellations, void, journal payments
Handle telephone calls for examiner as needed
Complete penalty calculations and prepare penalty worksheets
Complete MPN, HCO and/or EDI coding
Complete referrals to investigators
Complete preparation of documents for overnight delivery
Work collaboratively with Senior Claims Examiners, Nurse Case Managers, and other Assistant Claims Examiners
Contact with clients, injured workers, attorneys, doctors, vendors, and other parties
Provide updates of claims status to Senior Claims Examiners and Athens management
Prepare professional, well written correspondence and other communications
Essential Position Requirements
High School Diploma or equivalent (GED) required for all positions
AA/AS or BA/BS preferred but not required
2+ years’ Claims Assistant experience supporting a workers compensation examiner or team preferred
Medical Only Adjuster designation required
Continuing hours must be current
Mathematical calculating skills
Completion of IEA or equivalent courses
Administrators Certificate from Self-Insurance Plans preferred
Knowledge of workers compensation laws, policies, and procedures
Understanding of medical and legal terminology
Must demonstrate accuracy and thoroughness in work product
Ability to sit for prolonged periods of time
Well-developed verbal and written communication skills with strong attention to detail
Excellent organizational skills and ability to multi-task
Ability to type quickly, accurately and for prolonged periods
Proficient in Microsoft Office Suite
Ability to learn additional computer programs
Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution
Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization
Seeks to include innovative strategies and methods to provide a high level of commitment to service and results
Ability to demonstrate care and concern for fellow team members and clients in a professional and friendly manner
Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor
Athens’ operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company.
Must be able to reliably commute to meetings and events as required by this position
APPLY WITH US We look forward to learning about YOU! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at http://www.athensadmin.com/careers/job-openings. Feel free to include a cover letter if you’d like to share any other details. All applications received are reviewed by our in-house Corporate Recruitment team. The Company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link: https://dcba.lacounty.gov/wp-content/uploads/2024/08/FCOE-Official-Notice-Eng-Final-8.30.2024.pdf
Equal Opportunity Statement Athens Administrators is an Equal Opportunity/ Assertive Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development.
Thank You We look forward to reviewing your information. We understand that applying for jobs may not be the most enjoyable task, so we genuinely appreciate the time you’ve dedicated. Don’t forget to check out our website at www.athensadmin.com as well as our LinkedIn, Glassdoor, and Facebook pages!
Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company-Paid STD & LTD and more! Further information about our comprehensive benefits package may be found on our website at https://www.athensadmin.com/careers/why-work-here
Seniority level Entry level
Employment type Full-time
Job function Finance and Sales
Industries Insurance
Referrals increase your chances of interviewing at Athens Administrators by 2x
California, United States
Get notified about new Claims Examiner jobs in
California, United States .
#J-18808-Ljbffr