We are seeking a high-energy, goal-oriented Claims Resolution Specialist. If you are driven to achieve, here is your chance to be part of a stable, strong growing company and be rewarded for your hard work and contributions towards company goals and objectives. IWP is a national pharmacy service working on behalf of injured individuals. We are a market leader and rapidly expanding resource to injured patients and their advocates. When you join our fast-paced winning team, you’ll share in the continued success of a profitable, thriving, and unique pharmacy service. 

Under general supervision, performs a variety of professional duties in support of IWPs Workers’ Compensations pharmacy services. This position is responsible to expedite payment from Workers’ Compensation Insurance Carriers, monitor electronic billing rejections and maintain accounts receivable. Phone based position that requires constant contact with insurance carriers, third party administrators, and pharmacy benefit managers. 

WHAT YOU’LL DO

• Review, Investigate, and Analyze workers’ compensation claims and/or auto/personal injury claims to maximize recovery.
• Monitors electronic billing rejections and takes appropriate action.
• Ensures invoices are on file and obtains status of billing less than 60 days outstanding.
• Develop and maintain internal systems for data collection and entry, financial analysis, and report generation; create and update spreadsheets, logs, and diary as necessary.
• Serve as a liaison between insurance carriers, pharmacy benefit managers, patients, and internal company divisions.
• Attend and participate in staff meetings and keep supervisor informed of status on all assigned cases and plan of action. Stay abreast of new trends, pending legislation, and case law related to workers’ compensation.
• Negotiate settlements with insurance carriers within their granted settlement authority level.
• Pursue subrogation and arrange for salvage to obtain the maximum recovery.

WHAT YOU’LL NEED

• Bachelor’s Degree or equivalent experience.
• 1+ years Workers Compensation knowledge.
• Medical and technical terminology used in industrial injury cases.
• Basic principles and practices of analytical, statistical, and financial report preparation.
• Modern office procedures and methods including computer equipment and supporting applications.

MAKE A DIFFERENCE WITH IWP

Injured Workers Pharmacy (IWP) is proud to be THE Patient Advocate Pharmacy, helping injured workers around the country access their prescription medications with ease. As a specialized workers’ compensation home delivery pharmacy, we collaborate with the legal, medical, and insurance communities to help injured workers return to a productive life. At IWP we believe in our service, but it’s the people who make it a great place to work. We value our employees and strive for a culture of teambuilding, open mindedness, and fun. If that sounds like something you’d like to be part of, we’d love to hear from you! Your compensation will include a competitive salary, generous benefits, and opportunities for growth and development.

IWP is an Equal Opportunity Employer.  IWP does not discriminate on the basis of race, creed, color, religion, national origin, sex, sexual orientation, gender identity, age, physical or mental disability, or any other basis covered by appropriate law.  All employment decisions are made on the basis of qualifications, merit, and business need. IWP is committed to providing reasonable accommodations for qualified individuals with physical and mental disabilities in our job application procedures. If you need assistance or an accommodation due to a disability, you may contact us at humanresources@IWPharmacy.com   We will make a determination on your request for reasonable accommodation on a case-by-case basis.

Required Skills Required Experience

• Demonstrates general understanding and knowledge of front/back office standards, procedures, medical terminology and medical office practices.
• Demonstrates ability to read, write and communicate.
• Ability to handle multiple tasks, independently, under pressure.
• Knowledge of medical practice and care to assist in giving patient care.
• Knowledge of examination, diagnostic and treatment room procedures.
• Knowledge of medical equipment and instruments to administer patient care.
• Knowledge of common safety hazards and precautions to establish a safe working environment.
• Skill in establishing and maintaining effective working relationships with patients, medical staff and the public.
• Ability to maintain quality control standards.
• Ability to react calmly and effectively in emergency situations.
• Ability to interpret, adapt and apply guidelines and procedures.
• Ability to operate computer keyboard, terminal and printer, general office equipment, special medical and telephone equipment.