Athens Administrators
Assistant Claims Examiner
Company:
Athens Administrators
This role offers a competitive salary range between
$28.00/hr
and
$31.00/hr .
Position Details Position Title:
Assistant Claims Examiner
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
is a dynamic, innovative leader in claims administration since 1976. We foster an inclusive culture with opportunities for professional growth. Our nationwide, family‑owned company specializes in Workers' Compensation, Property & Casualty, Program Business, and Managed Care.
Position Summary The Assistant Claims Examiner supports the Workers’ Compensation department and is eligible to work from any California location. Employees within 26 miles of the Concord or Orange offices must visit once a week. The role involves clerical and technical assistance to Senior Claims Examiners, administration of Medical‑Only claims, and management of medical treatment and reserves.
Primary Responsibilities
Process new claims in compliance with client Service Agreements
Issue all indemnity payments and awards on time
Process all approved provider bills promptly
Prepare objection letters to providers for delayed, denied, or incomplete medical bills
Answer phone inquiries from medical providers regarding bills
Contact treating physicians about disability status
Contact employers for return‑to‑work status or modified work availability
Contact injured workers during initial setup
Send DWC notices promptly
Issue SJDB notices promptly
Request job descriptions from employers
Handle Medical‑Only claim files
Calculate wage statements and adjust disability rates as required
Maintain a diary of all delay dates and indemnity payments
Document file activity on computer
Update address and contact information on computer
Schedule appointments for AME and QME evaluations
Send appointment letters, issue TD/mileage, and forward medical files
Schedule interpreters for appointments and depositions
Request employer’s reports (DWC‑1, first report, etc.) if needed
Verify mileage and treatment dates for claimant reimbursement
Serve subpoenas for records
File and serve documents with attorneys, WCAB, and doctors
Serve PTPs with medical files and Duties of Treating Physician (9785)
Request PD ratings from DEU
Draft stipulated awards and C&R’s
Submit C&R and stipulated awards to WCAB for approval with documentation
Process checks: stop payments, cancellations, voids, journal entries
Handle telephone calls for the examiner as needed
Complete penalty calculations and prepare penalty worksheets
Complete MPN, HCO, or EDI coding
Complete referrals to investigators
Prepare documents for overnight delivery
Collaborate with Senior Claims Examiners, Nurse Case Managers, and other Assistants
Communicate with clients, injured workers, attorneys, doctors, vendors, and other parties
Provide status updates to Senior Examiners and Athens management
Prepare professional, well‑written correspondence and communications
Essential Position Requirements
High School Diploma or equivalent (GED) required; AA/AS or BA/BS preferred but not required
Minimum 2 years’ Claims Assistant experience supporting a Workers’ Compensation examiner or team preferred
Medical‑Only Adjuster designation required
Continuing education hours must be current
Strong mathematical and calculation 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
Demonstrated accuracy and thoroughness in work product
Ability to sit for prolonged periods
Excellent verbal and written communication skills with strong attention to detail
Excellent organizational skills and ability to multi‑task
Typing speed: quick, accurate, for prolonged periods
Proficient in Microsoft Office Suite
Ability to learn additional computer programs
Strong reasoning, problem‑solving, and analytical skills
Dependable and team‑oriented
Innovative approach to service and results
Considerate and courteous to team members and clients
Acts with integrity in challenging situations
Maintains honesty and integrity with confidential, proprietary information such as health records and financial data
Reliable commute to meetings and events as required
Apply With Us We look forward to learning about you. If you believe in our values of honesty, integrity, service, and a caring family culture, please submit your resume and application directly through our website at http://www.athensadmin.com/careers/job-openings. A cover letter is welcome.
All applications are reviewed by our in‑house Corporate Recruitment team. Athens Administrators 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 and their rights at https://dcba.lacounty.gov/wp-content/uploads/2024/08/FCOE-Official-Notice-Eng-Final-8.30.2024.pdf.
Equal Employment Opportunity Athens Administrators is an Equal Opportunity / Affluent 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 conditions of employment or career development.
Thank you for your interest. We appreciate the time you’ve dedicated to applying. Visit www.athensadmin.com and our LinkedIn, Glassdoor, and Facebook pages for more information.
#J-18808-Ljbffr
Athens Administrators
This role offers a competitive salary range between
$28.00/hr
and
$31.00/hr .
Position Details Position Title:
Assistant Claims Examiner
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
is a dynamic, innovative leader in claims administration since 1976. We foster an inclusive culture with opportunities for professional growth. Our nationwide, family‑owned company specializes in Workers' Compensation, Property & Casualty, Program Business, and Managed Care.
Position Summary The Assistant Claims Examiner supports the Workers’ Compensation department and is eligible to work from any California location. Employees within 26 miles of the Concord or Orange offices must visit once a week. The role involves clerical and technical assistance to Senior Claims Examiners, administration of Medical‑Only claims, and management of medical treatment and reserves.
Primary Responsibilities
Process new claims in compliance with client Service Agreements
Issue all indemnity payments and awards on time
Process all approved provider bills promptly
Prepare objection letters to providers for delayed, denied, or incomplete medical bills
Answer phone inquiries from medical providers regarding bills
Contact treating physicians about disability status
Contact employers for return‑to‑work status or modified work availability
Contact injured workers during initial setup
Send DWC notices promptly
Issue SJDB notices promptly
Request job descriptions from employers
Handle Medical‑Only claim files
Calculate wage statements and adjust disability rates as required
Maintain a diary of all delay dates and indemnity payments
Document file activity on computer
Update address and contact information on computer
Schedule appointments for AME and QME evaluations
Send appointment letters, issue TD/mileage, and forward medical files
Schedule interpreters for appointments and depositions
Request employer’s reports (DWC‑1, first report, etc.) if needed
Verify mileage and treatment dates for claimant reimbursement
Serve subpoenas for records
File and serve documents with attorneys, WCAB, and doctors
Serve PTPs with medical files and Duties of Treating Physician (9785)
Request PD ratings from DEU
Draft stipulated awards and C&R’s
Submit C&R and stipulated awards to WCAB for approval with documentation
Process checks: stop payments, cancellations, voids, journal entries
Handle telephone calls for the examiner as needed
Complete penalty calculations and prepare penalty worksheets
Complete MPN, HCO, or EDI coding
Complete referrals to investigators
Prepare documents for overnight delivery
Collaborate with Senior Claims Examiners, Nurse Case Managers, and other Assistants
Communicate with clients, injured workers, attorneys, doctors, vendors, and other parties
Provide status updates to Senior Examiners and Athens management
Prepare professional, well‑written correspondence and communications
Essential Position Requirements
High School Diploma or equivalent (GED) required; AA/AS or BA/BS preferred but not required
Minimum 2 years’ Claims Assistant experience supporting a Workers’ Compensation examiner or team preferred
Medical‑Only Adjuster designation required
Continuing education hours must be current
Strong mathematical and calculation 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
Demonstrated accuracy and thoroughness in work product
Ability to sit for prolonged periods
Excellent verbal and written communication skills with strong attention to detail
Excellent organizational skills and ability to multi‑task
Typing speed: quick, accurate, for prolonged periods
Proficient in Microsoft Office Suite
Ability to learn additional computer programs
Strong reasoning, problem‑solving, and analytical skills
Dependable and team‑oriented
Innovative approach to service and results
Considerate and courteous to team members and clients
Acts with integrity in challenging situations
Maintains honesty and integrity with confidential, proprietary information such as health records and financial data
Reliable commute to meetings and events as required
Apply With Us We look forward to learning about you. If you believe in our values of honesty, integrity, service, and a caring family culture, please submit your resume and application directly through our website at http://www.athensadmin.com/careers/job-openings. A cover letter is welcome.
All applications are reviewed by our in‑house Corporate Recruitment team. Athens Administrators 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 and their rights at https://dcba.lacounty.gov/wp-content/uploads/2024/08/FCOE-Official-Notice-Eng-Final-8.30.2024.pdf.
Equal Employment Opportunity Athens Administrators is an Equal Opportunity / Affluent 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 conditions of employment or career development.
Thank you for your interest. We appreciate the time you’ve dedicated to applying. Visit www.athensadmin.com and our LinkedIn, Glassdoor, and Facebook pages for more information.
#J-18808-Ljbffr