Bill Review Trainer - Hearing Specialist

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Bill Review Trainer - Hearing Specialist

PRIMARY PURPOSE : To develop and conduct technical training for all new and existing departmental colleagues; to represent client employers at hearings before the appropriate judicial body. Negotiate Workers' Compensation medical liens following unit guidelines, in house resolution unit.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Reviews upcoming hearings and prepares necessary documentation to represent clients' interests; supports legal counsel in regard to hearings; appears before the judicial body on behalf of clients.

• Reviews state files to update company files accordingly.

• Performs lien negotiations.

• Develops and maintains departmental technical training materials.

• Trains and monitors progress of new departmental colleagues; trains existing departmental colleagues on procedural and system changes.

• Provides training for colleagues in other departments as required.

• Assists in development and maintenance of departmental policies and procedures.

• Completes special projects as required.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Primary role to perform as Medical Lien Negotiator on behalf of the Lien Resolution Unit

• Handle all aspects of research, file review, and negotiation of outstanding medical lien

• Prepare lien settlements

• Must be experienced with Worker's Compensation Labor Codes, WCAB Court procedures, and setting

• Timely resolution and follow up on pending files

• Must be organized and detail oriented with ability to adapt fast pace environment

• Must have excellent computer skills and ability to trouble shoot technical issues in Work From Home environment

• Supports the organization's quality program(s).

• Performs other duties as assigned.

• A plus if located central to the DWC Boards

• Travels as required.

QUALIFICATIONS

Education & Licensing

Bachelor's degree from an accredited college or university preferred.

Experience

Five (5) years of experience in workers' compensation field in a high client-contact position or equivalent combination of education and experience required.

Skills & Knowledge

• Excellent knowledge of billing codes

• PC literate, including Microsoft Office products

• Leadership/management/motivational skills

• Strong analytical and interpretive skills

• Strong problem solving skills

• Strong interpersonal skills

• Excellent negotiation skills

• Ability to work in a team environment

• Ability to work independently

• Ability to be flexible and handle multiple/changing priorities

• Ability to meet or exceed Performance CompetenciesExcellent oral and written communication, including presentation skills

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical: Computer keyboarding, travel as required

Auditory/Visual: Hearing, vision and talking

NOTE : Credit security clearance, confirmed via a background credit check, is required for this position.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ( $55,000 - $66,000 ). A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Taking care of people is at the heart of everything we do. Caring counts

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (~~~)