Workers’ Compensation Resolution Specialist I

Description

A Little Bit About Us

If you're looking for a rewarding career at a company with a supportive workplace culture and unlimited potential for growth, consider Gemini Legal. We are a dynamic, industry-leading, technology-based company headquartered in Rocklin, California. Gemini provides support services to California attorneys, collecting digital records and offering vocational counseling to injured workers.

Our management team has an open-door policy, and our exceptional growth is credited solely to our team members and their dedication to collaborate, achieve and give back. Success is celebrated and integrity is the essence of who we are.

Ethical. Passionate. Smart. These three tenets drive our diverse team, and we welcome dedicated individuals to apply to join our work family.

A Little Bit About The Position

The Workers’ Compensation (WC) Resolution Specialist I’s primary responsibility is to manage and resolve accounts/cases associated with workers' compensation claims in outstanding AR greater than 1 year. This role demands a strong understanding of workers' compensation regulations, excellent negotiation skills, and the ability to collaborate with multiple stakeholders. An additional objective is analyzing and preparing cases for the possibility of litigation. This position includes compliance with HIPAA, state and federal document security regulations. Specialists receive advanced training in workers’ compensation laws, regulations, and copy service fee schedules related to all aspects of billing, collections, objections, and the regulatory landscape related to specifically copy service.

• Location: West Covina, CA/Hybrid-Remote
• Schedule: Monday-Friday, 8:00am-5:00pm
• Compensation: $24.04-$30.77 Per Hour
  
  

Requirements

RESPONSIBILITIES

• Review, assess, and analyze cases associated with workers' compensation claims to determine their validity and accuracy
• Conduct comprehensive research and gather necessary documentation to support negotiations and resolutions
• Negotiate with claims adjusters, lien resolution specialists, defense attorneys, and other relevant parties, to reach fair and reasonable settlements
• Ensure compliance with all relevant workers' compensation laws, regulations, and guidelines in lien resolution activities
• Maintain effective communication with various stakeholders, including claims adjusters, attorneys, lien units, clients, and internal stakeholders to update them on the progress of case resolution
• Maintain detailed records of all resolution activities, including agreements, payments, and any relevant correspondence
• Create and maintain detailed analysis of cases in preparation of litigation
• Record keeping of payment pursuant to settlement agreements and correspondence with a guarantee of payment
• Handle any disputes or conflicts related to lien resolution in a professional and diplomatic manner
• Identify opportunities to minimize costs associated with resolution of cases while upholding legal and ethical standards
• Stay updated on changes in workers' compensation laws and regulations, and attend training sessions or workshops as necessary
• May handle collections of the Voucher and/or Civil AR, requiring basic workers’ compensation knowledge related to vouchers
• Other duties as required
  
  

Experience, Skills And Abilities

• Education and/or experience:
• High School diploma or equivalent is required
• 1-3 years of experience in the workers’ compensation field required
• Skills:
• Typing speed of at least 35 WPM with 90% accuracy
• Understanding of workers' compensation regulations
• Ability to collaborate with multiple stakeholders
• Comprehensive skills in process writing and flow chart mapping
• Ability to effectively negotiate
• Excellent verbal and written communication skills, including proof-reading, syntax, and grammar
• General computation skills, including the use of a calculator
• Technology
• Proficient using a computer, business phone, office software, video conferencing, and other computer programs including Google Workplace (Docs, Sheets, Calendar, Gmail, etc.) and Microsoft applications
• Ability to complete data entry with a high level of accuracy
  

Functional Requirements

Must be able to perform the essential functions of the position with or without accommodation, including, but not limited to:

• Sitting for at least one hour at a time (total: 4-6 hours/day)
• Keyboarding for extended periods of time (total: 4-6 hours/day)
• Using a phone with or without a headset for extended periods (total: 3-5 hours/day)
  
  

What You'll Love About Gemini

• Comprehensive health coverage including medical, dental, and vision
• Generous time-off to support work-life balance including PTO, volunteer time, sick time, and paid holidays
• 401(k) plan with company match to support your financial future
• Company culture rooted in shared values and community
• Education tuition reimbursement program
• Employee Assistance Program (EAP) and legal assistance benefit
• Company-paid annual donation to a non-profit or charity of your choice
• Employee recognition program with gifts and awards
  
  

Salary Description

$24.04-$30.77 Per Hour