Direct message the job poster from randstad méxico
about the company: randstad is the #1 hr services provider in the world, and we are hiring a claims advisor to join our nearshore center at randstad mexico.
what you will be doing:
* intake claims from the field, file claims with tpa, determine the course and scope of each investigation; which may include background reports, third party subject matter expert, surveillance and data mining. Must document any initial red flags, identify needs based on each situation and take prompt action to ensure randstad is positioned properly for potential financial exposure. Secure confirmation from the field or medical provider of each injured worker’s post injury work status and placement. Immediately escalate any significant claim exposures as they arise. Constantly monitoring shared inbox for new claim information.
* document all communication properly in our system of record, following instructions in department standard work.
* strive to meet or exceed the performance expectations for branch connects, talent connects, timely transmission of claim to tpa, claim audit scores, intake complete timely, and maintaining acceptable phone metrics.
* work well in a team environment to ensure all necessary parties are updated when changes or updates occur.
* accurately code and assign claims to the correct analyst based on claim type, branch unit number, line of business, and/or geographical territory to ensure p&l allocations are correct.
education & qualifications:
high school diploma or equivalent required. Some college preferred.
1-3 years professional or corporate administrative assistant experience required.
1-3 years entry level claims experience preferred.
minimum of 1-2 years verifiable experience working in a fast paced, customer service oriented, team based environment required.
proficient with basic computer software tools including word, excel, powerpoint, and google.
strong customer focus, detail oriented, interpersonal, and customer service skills.
experience in claims, insurance or workers’ compensation preferred.
proficient in english and spanish.
decision making authority:
approval of initial strategic direction to tpa and third party vendors on plan of action.
approval of investigative assignments, data mining, medical history search, and aoe/coe referrals.
* 100% remote position.
* direct contract with randstad mexico.
* attractive compensation & benefits package.
at randstad, we love to celebrate our hardworking diverse teams demonstrated through our ongoing commitment and diversity awards. We are proud of our collaborative culture which is at the heart of randstad. When you join randstad, you will receive opportunities for competitive & robust benefits, flexible schedules, and the assurance that everyone can be their authentic selves. We are seeking candidates from all backgrounds and demographics and a variety of industries to join a winning team!
equal opportunity employer: race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, protected veteran status, or any other legally protected group status. At randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants.
seniority level
mid-senior level
employment type
full-time
job function
analyst
industries
human resources
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