The Medical Only Claims Specialist II position at AF Group in Lansing, MI, involves managing and investigating workers' compensation claims with minimal supervision. The ideal candidate will have a background in insurance, particularly in claims management, and possess strong communication and analytical skills
Job Summary
The incumbent is expected to perform at a high level with minimum supervision while investigating and managing workers' compensation claims.
Responsibilities include determining compensability, managing medical treatment programs, and confirming disability timelines within specific waiting periods.
The role requires establishing timely reserves based on financial exposure and ensuring compliance with state legislation to avoid penalties.
Matching Summary
Match Score: 85
The Medical Only Claims Specialist II position at AF Group in Lansing, MI, involves managing and investigating workers' compensation claims with minimal supervision. The ideal candidate will have a background in insurance, particularly in claims management, and possess strong communication and analytical skills.
Skills & Requirements
Must-have
Workers compensation claims investigation
Medical treatment program management
Multi-state jurisdictional knowledge
Compensability determination skills
Reserve calculation and documentation
Provider and claimant communication
Nice-to-have
Mentoring team members
Agent and policyholder visits
Cost containment vendor coordination
Return-to-work process support
Advanced case law interpretation
Key Requirements
MI or TX license required
1 year MOCS I experience OR 3 years insurance experience