Are you driven to keep people safe? That’s what we do every day at MEM Insurance.

We’ve created a casual, values-driven work culture that’s making a positive impact on the way people live and work. This is a place where you can grow with confidence — because that’s what safety and success really mean to us.

SUMMARY:
The Claims Care Advocate provides critical administrative support and workflow management within the Claims Department. This role ensures smooth operations across multiple functions, including Claims Operations, Subrogation/Technical Services, and Nurse Case Management. The Claims Care Advocate is responsible for a variety of tasks ranging from transcribing records and processing bill payments to managing records requests and responding to customer inquiries. This position plays a key role in maintaining high service standards and delivering excellent customer service.

ESSENTIAL DUTIES AND RESPONSIBILITIES:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Functional Administrative Support

• Provide comprehensive support across all Claims functions including Operations, Subrogation, Ligation Technical Services, Nurse Case Management and externally to our Policyholders and Producers.
• Manage requests for offer letters, rating requests, earnings affidavits, wage statements, medical records, and other essential documentation.
• Coordinate and process requests such as OSHA reports, conservation records, police reports, death certificates, and driver’s license suspensions.
• Prepare and send claim files to attorneys and subrogation adjusters as needed.
• Manage collections activities and certified mailings through Stamps.com. Reconcile monthly expenses.
• Coordinate logistics for injured workers and adjusters, to include hotel reservations through Commerce Bank, scheduling appointments for IME’s, follow-ups and transportation.

• Manage and process records requests through third-party vendors, ensuring timely and efficient retrieval.

• Index tasks and ensure all necessary information is accurately captured for efficient claims review.
• Index and process claims, ensuring all necessary information is accurately captured for efficient claims review.
• Respond to customer inquiries via email, fax and web, while maintaining professionalism and adherence to service standards.
• Follow established Claims procedures for document processing, including correct grammar, formatting, and document attachment guidelines.
• Process claim entry by gathering all necessary information and identifying initial compensability, including possible violations, and documenting claims appropriately to comply with regulatory guidelines.
• Maintain and handle activities in ClaimCenter Queues and tasks in ImageRight.
• Partner with multiple external vendors, to include Corvel, OneCall, MetroReporting, and HomeLink.
• Timely processing of Division of Workers Compensation requests, such as form 21, 22, information request and address changes.

• Serve as first point of contact for customer inquiries via phone and chat, while providing accurate and timely information.
• Ensure all communications are clear, professional, and adhere to company standards.
• Promote company services to policyholders, producers, medical providers, injured workers, and attorneys when applicable.

• High School graduation or equivalent is required. A bachelor’s degree is preferred

• None required.

• A valid drivers’ license is required.

• 1 plus year experience in a professional office environment. Exposure to Workers’ Compensation or similar industry experience preferred