Medical Only Claims Examiner
Group 1001

Job Info

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Group 1001 is a consumer-centric, technology-driven family of insurance companies on a mission to deliver outstanding value and operational performance by combining financial strength and stability with deep insurance expertise and a can-do culture. Group1001's culture emphasizes the importance of collaboration, communication, core business focus, risk management, and striving for outcomes. This goal extends to how we hire and onboard our most valuable assets - our employees.

Company Overview:

Clear Spring Property and Casualty Group (CSPCG) is comprised of four insurance carriers (Clear Spring Property and Casualty Company, Clear Spring Casualty Insurance Company, Clear Spring American Insurance Company, and Clear Spring National Insurance Company), each rated A- (Excellent) by A.M. Best. CSPCG assists companies in protecting themselves from today's challenges through technology and innovation. CSPCG provides worker's compensation, general liability, and other coverages through strong agency relationships.

Clear Spring Property and Casualty Group is a subsidiary of Delaware Life Insurance Company and its parent company, Group 1001, a collective that empowers companies to create positive growth. Everything Group 1001 does is designed to help individuals and communities thrive. Our insurance and annuities make financial products easy to understand and accessible to all. Our online investing platform gives individuals control over their savings and their futures. Our technology and innovation help companies succeed. And our strategic partnerships bring people together through education and sports. Because we all have the power to grow better. Clear Spring's risk management solutions evolve with market needs, while traditional insurance companies struggle to keep up. Our data-driven approach and mastery of emerging technologies provide a deeper connection with customers by developing smarter, more adaptive ways to interact that address the needs of brokers and their policyholders.

We're confident that you'll love partnering with us.

Group 1001, and its affiliated companies, is strongly committed to providing a supportive work environment where employee differences are valued. Diversity is an essential ingredient in making Group 1001 a welcoming place to work and is fundamental in building a high-performance team. Diversity embodies all the differences that make us unique individuals. All employees share the responsibility for maintaining a workplace culture of dignity, respect, understanding and appreciation of individual and group differences.

Clear Spring Property and Casualty Group (CSPCG) is comprised of four insurance carriers (Clear Spring Property and Casualty Company, Clear Spring Casualty Insurance Company, Clear Spring American Insurance Company, and Clear Spring National Insurance Company), each rated A- (Excellent) by A.M. Best. CSPCG assists companies in protecting themselves from today's challenges through technology and innovation. CSPCG provides worker's compensation, general liability, and other coverages through strong agency relationships.

Clear Spring Property and Casualty Group is a subsidiary of Delaware Life Insurance Company and its parent company, Group 1001, a collective that empowers companies to create positive growth. Everything Group 1001 does is designed to help individuals and communities thrive. Our insurance and annuities make financial products easy to understand and accessible to all. Our online investing platform gives individuals control over their savings and their futures. Our technology and innovation help companies succeed. Our strategic partnerships bring people together through education and sports. Because we all have the power to grow better.

Clear Spring's risk management solutions evolve with market needs, while traditional insurance companies struggle to keep up. Our data-driven approach and mastery of emerging technologies provide a deeper connection with customers by developing smarter, more adaptive ways to interact that address the needs of brokers and their policyholders. We're confident that you'll love partnering with us.

Job Summary

The Medical Only Examiner reports to the Claims Manager and is responsible for all aspects of handling medical only Workers' Compensation claims from initial set up through claim closure. This role involves frequent interaction with insureds, claimants, and medical providers.

Main Accountabilities

• Provide exceptional customer service consistent with the philosophy of Clear Spring Property and Casualty Group.
• Review incoming bills and treatment notes for causality.
• Process daily mail and payments.
• Maintain contact with claimant, insured, and medical providers on medical only files.
• Identify files that need to be transferred to a Claims Consultant when change in status to a "Lost Time" file is apparent. Make transfer in a timely manner.
• Complete any Bureau or other legal documents as appropriate.
• Request reserves and provide reasoning for increase on files when necessary.
• Provide claims knowledge to policyholders.
• Communicate verbally and in writing with stakeholders in an effective and professional manner.
• Ensure data submitted is accurate, timely, and in compliance with all requirements.
• Monitor and complete transactions in a timely and accurate method in required computer programs.
• Other duties as assigned that contribute to the overall productivity and well-being of the company.

Qualifications

• Minimum of one-year experience in the insurance industry required.
• Prior Workers' Compensation and medical terminology experience preferred.
• Strong time-management, communication, and PC skills.
• Proficiency in Microsoft Office required.
• Proven ability to build strong working relationships.

Compensation:

Our compensation reflects the cost of labor across several U.S. geographic markets. The base pay for this position ranges from $34,300/year in our lowest geographic market up to $72,300/year in our highest geographic market. Pay is based on a number of factors including market location and may vary depending on job-related knowledge, skills, and experience.

Benefits Highlights:

Employees who meet benefit eligibility guidelines and work 30 hours or more weekly, have the ability to enroll in Group 1001's benefits package. Employees (and their families) are eligible to participate in the Company's comprehensive health, dental, and vision insurance plan options. Employees are also eligible for Basic and Supplemental Life Insurance, Short and Long-Term Disability, and to enroll in the Company's Employee Assistance Program and other wellness initiatives. Employees may also participate in the Company's 401K plan, with matching contributions by the Company.
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