Claims Assistant, Workers

Job Details Level: Entry

Job Location:

Granite Bay BETA office - Roseville, CA 95661

Position Type:
Full Time Education Level: High School Salary Range: $26.67 - $29.74 Hourly Travel Percentage:
Negligible Job Shift: Day Our Claims team is looking for a new Claims Assistant to add to our Workers’ Compensation team! We are a fun, fast-paced team who work hard for our members. Are you organized and can communicate effectively with members? Do you do well under pressure and changing priorities? Do you like working in a collaborative team environment?

Do you have a track record of anticipating problems, evaluating and making good decisions? Are you interested in expanding your career in Workers' Compensation Claims Management? If so, our team is looking for you!

BETA Healthcare Group (BETA) is the largest professional liability insurer of hospitals on the west coast, providing coverage to more than 600 hospitals and healthcare facilities and provides workers' compensation coverage for over 90,000 healthcare workers in California. BETA also has a long-established and growing commitment to physicians, providing medical professional liability coverage to nearly 7,700 physicians and more than 70 medical groups.

Beyond primary liability and workers’ compensation coverage, BETA provides an entire suite of alternative risk and insurance services, including excess healthcare professional liability coverage, excess workers’ compensation coverage, third-party claims administration services, risk management consulting services and claims management consulting services. Whether with hospitals, medical groups, clinics or hospices, BETA has earned a reputation for financial strength, rate stability, quality service and breadth of coverage that is unparalleled in the industry.

In this role, you will assist claims examiners in the administration of Workers’ Compensation Claims for our members. This position will allow working from home up to 2 days a week and must be located a commutable distance to the Granite Bay office.

• Processes payments
• Call treating physician for work status update
• Call employer for determination of mod-duty / RTW status and potential Wage-Loss
• Complete wage loss calculation within 14 days of receipt and document in claims system
• Calculate wage statements within 14 days of receipt and make necessary adjustments to pay rate as needed
• Maintain ongoing diary system for timely benefit payments
• Update notepads with each payment made
• Set up (per examiner) and monitor autopay system

• Complete 2-point contact on assigned indemnity claims (to include ER and physician contact)
• Call physician for employee medical status, as appropriate
• Record detailed summary of injury and all facts/details of loss in “accident info” notepad
• May send defense attorney referrals with appropriate records
• Send WCAB settlement packages according to their guidelines
• Set appointment for injured workers as needed
• Send permanent and stationary reports along with all necessary information to disability evaluation unit for permanent disability rating
• Copy work for clerical support as needed and reinsurance as needed
• Pay mileage and Rx reimbursements
• Subpoena records, as instructed
• May prepare and mail objection notices to vendors, etc.
• Maintain diary and mail currency according to company standards
• Respond to email and/or telephonic inquiries according to company policies
• Provide courteous and professional service
• Complete time sheet reflecting accurate hours worked each day
• Reports for work on time and maintains a satisfactory attendance record
• Other duties as assigned

• High school diploma or G.E.D. required.
• Minimum of one (1) year experience as a Claims Clerk, Claims Assistant, or similar role preferred
• General knowledge of basic W.C.
• Passed the I.E.A. or The Institutes CA 10 and medical terminology course preferred
• Strong organizational and multi-tasking skills
• Solve problems and properly calculate benefits using mathematics; identify appropriate solutions using logic and reasoning
• Gather facts using verbal, non-verbal (active listening)…