Job Title: Claims Assistant
Location: Springfield, IL or Middleton, WI
Pay Range: $20-22/hour
Role Overview:
The Claims Assistant supports the workers’ compensation claims team with claims processing, data entry, digital file maintenance, and administrative support. This role will focus heavily on reducing the existing claims backlog, maintaining accurate claim records, completing required claim reviews, and ensuring information is properly documented across claims systems. The ideal candidate is comfortable working in a fast-paced environment, and has 1–2 years of relevant claims processing experience, preferably in workers’ compensation.
Key Responsibilities:
- Process and organize digital claim records by removing duplicate records, organizing documents, and maintaining file uniformity
- Complete required 10-day and 6-month claim maintenance checklists and process data corrections as needed
- Perform manual Medicare queries through the CMS COB&R site and document findings within the digital claim record
- Process class code corrections to accurately reflect an injured worker’s job duties and payroll information
- Complete and maintain claim documentation in PowerSuite and ImageRight
- Process claim closures, re-openings, and reassignments as directed by supervisory personnel
- Assist with record subpoenas and complete lien reviews using worksheet summaries
- Process vendor referrals based on service specialty and submit utilization reviews to the appropriate vendors
- Process Maximus responses following IMR to ensure timely completion
- Review adjuster tasks in ImageRight daily for medical authorization requests
- Provide administrative and claims-processing support to adjusters and other members of the claims team
- Provide backup support for entering manual payments for the Claims Payable Analyst
- Assist with backlog reduction and other data-entry projects within the claims operations system
Qualifications:
- 1–2 years of relevant claims processing experience, preferably in workers’ compensation or a similar field
- Ability to manage multiple priorities and work effectively under pressure in a fast-paced environment
- Some college coursework is a plus
Brilliant Staffing, LLC is an Equal Opportunity Employer and encourages applications from all individuals regardless of race, color, religion, gender, gender identity, sexual orientation, national origin, disability, or veteran status.