Athens Administrators

Role Description Athens Administrators has an immediate need for a full-time Senior Claims Examiner to support our workers compensation department. Employees who live less than 26 miles from the San Antonio, TX office are required to work once a week in the office on a day determined by their supervisor between Tuesday – Thursday. The remaining days can be worked remotely if technical requirements are met, and the employee resides in Texas. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday-Friday at 37.5 hours a week with the option of a flex schedule. The Senior Claims Examiner will adjust workers’ compensation claims from inception through settlement and closure, ensuring timely processing of claims and payment of benefits, managing, and directing medical treatment, setting reserves, and negotiating settlements. Qualifications - High School Diploma or equivalent (GED) required for all positions - AA/AS or BA/BS preferred but not required - The Texas 03 Workers’ Compensation license is required - The 08 All Lines License is preferred - 3+ years recent workers compensation claims handling experience required - At least 5 years of workers compensation claims experience preferred - Solid knowledge of workers compensation laws, policies, and procedures - Completion of IEA or equivalent courses - Proficiency in determining case value and negotiating settlements - Understanding of medical and legal terminology - Mathematical calculating skills - Well-developed verbal and written communication skills with strong attention to detail - Excellent organizational skills and ability to multi-task - Ability to type quickly, accurately and for prolonged periods - Proficient in Microsoft Office Suite - Ability to learn additional computer programs - Reasoning ability, including problem-solving and analytical skills - Ability to be trustworthy, dependable, and team-oriented - Seeks to include innovative strategies and methods to provide a high level of commitment to service and results - Ability to demonstrate care and concern for fellow team members and clients - Acts with integrity in difficult or challenging situations Requirements - Must be able to reliably commute to meetings and events as required by this position - Athens’ operations involve handling confidential, proprietary, and highly sensitive information Benefits - Medical, Vision, Dental, Life and AD&D insurance - Long Term Care, Critical Care, Accidental, Hospital Indemnity - HSA & FSA options - 401k (and Roth) - Company-Paid STD & LTD - Eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Athens Administrators has an immediate need for an experienced Assistant Claims Examiner to support our Workers’ Compensation department and can be located anywhere in the state of California. Employees who live less than 26 miles from the Concord, CA or Orange, CA offices are required to work once a week in the office on a day determined by their supervisor between Tuesday – Thursday. The remaining days can be worked remotely if technical requirements are met, and the employee resides in California. The schedule for this position is Monday-Friday at 37.5 hours a week with the option of a flex schedule. - Provide clerical and technical assistance to Senior Claims Examiners - Administer Medical Only claims, ensuring timely processing of claims and payment of benefits - Manage and direct medical treatment, and set reserves - Use fluent Spanish skills with claimants on the account Primary Responsibilities - Process new claims in compliance with client’s Service Agreement - Issue all indemnity payments and awards on time - Process all approved provider bills timely - Prepare objection letters to providers for medical bills; delayed, denied, lacking reports - Answer questions over the phone from medical providers regarding bills - Contact treating physician for disability status - Contact employer for return-to-work status or availability of modified work - Contact injured worker at initial set up - Send DWC notices timely - Issue SJDB Notices timely - Request Job Description from Employer - Handle Medical Only claim files - Calculate wage statements and adjust disability rates as required - Keep diary for all delay dates and indemnity payments - Document file activity on computer - Update information on computer, i.e., address changes, etc. - Schedule appointments for AME, QME evaluations - Send appointment letters, issue TD/mileage, send medical file - Schedule interpreter for appointments, depositions, etc. - Request Employer’s Report, DWC-1, Doctor’s First Report if needed - Verify mileage and dates of treatment for reimbursement to claimant - Subpoena records - File and serve documents on attorneys, WCAB, doctors - Serve PTP’s with medical file and Duties of Treating Physician (9785) - Request PD ratings from DEU - Draft Stipulated Awards and C&R’s - Submit C&R, Stipulated Awards to WCAB for approval with documentation - Process checks – stop payment, cancellations, void, journal payments - Handle telephone calls for examiner as needed - Complete penalty calculations and prepare penalty worksheets - Complete MPN, HCO and/or EDI coding - Complete referrals to investigators - Complete preparation of documents for overnight delivery - Work collaboratively with Senior Claims Examiners, Nurse Case Managers, and other Assistant Claims Examiners - Contact with clients, injured workers, attorneys, doctors, vendors, and other parties - Provide updates of claims status to Senior Claims Examiners and Athens management - Prepare professional, well written correspondence and other communications Essential Position Requirements - High School Diploma or equivalent (GED) required for all positions - AA/AS or BA/BS preferred but not required - 2+ years’ Claims Assistant experience supporting a workers compensation examiner or team preferred - Medical Only Adjuster designation required - Fluency in Spanish required - Continuing hours must be current - Mathematical calculating skills - Completion of IEA or equivalent courses - Administrators Certificate from Self-Insurance Plans preferred - Knowledge of workers compensation laws, policies, and procedures - Understanding of medical and legal terminology - Must demonstrate accuracy and thoroughness in work product - Ability to sit for prolonged periods of time - Well-developed verbal and written communication skills with strong attention to detail - Excellent organizational skills and ability to multi-task - Ability to type quickly, accurately and for prolonged periods - Proficient in Microsoft Office Suite - Ability to learn additional computer programs - Reasoning ability, including problem-solving and analytical skills - Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization - Seeks to include innovative strategies and methods to provide a high level of commitment to service and results - Ability to demonstrate care and concern for fellow team members and clients in a professional and friendly manner - Acts with integrity in difficult or challenging situations Apply With Us We look forward to learning about YOU! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at http://www.athensadmin.com/careers/job-openings . Feel free to include a cover letter if you’d like to share any other details.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Athens Administrators has an immediate need for a Claims Supervisor to support our Southern California Workers Compensation department. Management that lives less than 36 miles from the Orange, CA office AND have a direct report in the office, are required to work once a week in the office. The remaining days can be worked remotely if technical requirements are met, and the employee resides in Southern California. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. Employee work a 37.5-hour work week with the ability to work a flex schedule with every third Monday or Friday off. As a Claims Supervisor, you'll play a pivotal role in leading and collaborating with Athens management to achieve exciting company goals, run insightful reports, and streamline processes. You'll make impactful daily claims decisions, review files for accuracy, and approve payments that exceed examiner authority. Additionally, you'll ensure top-notch file handling, accurate claims coding, and meet unit closing goals. You'll be the guiding force for your team, planning, organizing, delegating workloads, supervising daily activities, providing training, and offering valuable guidance. In client management, you'll address policy and claims issues, build and maintain strong relationships, attend key meetings, ensure compliance with client instructions, and document interactions, always acting in the client's best interest. Join us and make a difference every day! Qualifications - High School Diploma or GED required; AA/AS or BA/BS preferred - Must possess a current Experienced Indemnity Claims Adjuster Designation, provided by an insurer, as defined in California Code of Regulations, Title 10, Chapter 5, Subchapter 3, Section 2592.01(f) - Administrators Certificate from Self-Insurance Plans. If not already obtained, the Administrators Certificate from Self-Insurance Plans will be required within one year of employment - Completion of IEA or equivalent courses - Minimum 3+ years of recent California workers’ compensation claims handling experience at a high level - At least 2 years of Claims Supervisory experience required - 5+ years’ experience in a workers’ compensation lead or supervisor position preferred - Prior Third‑Party Administrator (TPA) experience preferred - In-depth knowledge of California workers’ compensation laws, policies, and procedures - Proficiency in determining case value, reserving, and negotiating settlements - Understanding of medical and legal terminology - Proficient in Microsoft Office Suite; ability to learn additional systems (e.g., ClaimsXpress) - Able to plan, prioritize, and organize claims workload for a unit Requirements - Ability to lead by example, delegate effectively, and ensure timely task completion, even during stressful situations and tight deadlines - Demonstrated ability to influence, coach, and motivate staff to achieve unit and organizational goals - Strong organizational and time-management skills; able to plan, prioritize, and manage unit workloads - Flexible, adaptable, positive, and aligned with Athens Values - Ability to develop and maintain effective working relationships with coworkers, clients, vendors, and key stakeholders - Strong analytical, reasoning, and problem-solving skills - Highly developed written and verbal communication skills - Ability to handle confidential, proprietary, and highly sensitive information appropriately - Valid driver’s license and ability to travel, including in-office file reviews and meetings - Ability to type quickly and accurately for sustained periods Benefits - Comprehensive health insurance - 401(k) with company match - Eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments - Variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, Company-Paid STD & LTD and more Company Description Athens Administrators has been dynamic, innovative leaders in claims administration since our founding in 1976. We foster an environment where employees not only thrive but consistently recognize Athens as a “Best Place to Work.” Immerse yourself in our engaging, supportive, and inclusive culture, offering opportunities for continuous professional growth. Join our nationwide family-owned company in Workers' Compensation, Property & Casualty, Program Business, and Managed Care.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Athens Administrators has an immediate need for a full-time Bilingual Senior Claims Examiner to support our workers compensation offices and can be located anywhere in Southern California. Employees who live less than 26 miles from the Orange, CA offices are required to work once a week in the office on a day determined by their supervisor between Tuesday – Thursday. The remaining days can be worked remotely if technical requirements are met, and the employee resides in Southern California. The schedule for this position is Monday-Friday at 37.5 hours a week with the option of a flex schedule. - Adjust workers’ compensation claims from inception through settlement and closure - Ensure timely processing of claims and payment of benefits - Manage and direct medical treatment - Set reserves and negotiate settlements - Use fluent Spanish skills with claimants on the account Qualifications - Fluency in Spanish required - High School Diploma or equivalent (GED) required for all positions - AA/AS or BA/BS preferred but not required - Administrators Certificate from Self-Insurance Plans will be required within one year of employment if not already obtained - Must possess a current Experienced Indemnity Claims Adjuster Designation, provided by an insurer, as defined in California Code of Regulations, Title 10, Chapter 5, Subchapter 3, Section 2592.01(f) - 3+ years recent workers compensation claims handling experience required - At least 5 years of workers compensation claims experience preferred - Solid knowledge of workers compensation laws, policies and procedures - Completion of IEA or equivalent courses - Proficiency in determining case value and negotiating settlements - Understanding of medical and legal terminology - Mathematical calculating skills - Well-developed verbal and written communication skills with strong attention to detail - Excellent organizational skills and ability to multi-task - Ability to type quickly, accurately and for prolonged periods - Proficient in Microsoft Office Suite - Ability to learn additional computer programs - Reasoning ability, including problem-solving and analytical skills - Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization - Seeks to include innovative strategies and methods to provide a high level of commitment to service and results - Ability to demonstrate care and concern for fellow team members and clients in a professional and friendly manner - Acts with integrity in difficult or challenging situations Requirements - Athens’ operations involve handling confidential, proprietary, and highly sensitive information - Must be able to reliably commute to meetings and events as required by this position Benefits - Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options - 401k (and Roth) - Company-Paid STD & LTD - Eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments Company Description We have been dynamic, innovative leaders in claims administration since our founding in 1976. We foster an environment where employees not only thrive but consistently recognize Athens as a “Best Place to Work.” Immerse yourself in our engaging, supportive, and inclusive culture, offering opportunities for continuous professional growth.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Athens Administrators has an immediate need for a full-time Senior Claims Examiner to support our workers compensation department. Employees who live less than 26 miles from the San Antonio, TX office are required to work once a week in the office on a day determined by their supervisor between Tuesday – Thursday. The remaining days can be worked remotely if technical requirements are met, and the employee resides in Texas. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday-Friday at 37.5 hours a week with the option of a flex schedule. - Adjust workers’ compensation claims from inception through settlement and closure - Ensure timely processing of claims and payment of benefits - Manage and direct medical treatment - Set reserves and negotiate settlements Qualifications - High School Diploma or equivalent (GED) required for all positions - AA/AS or BA/BS preferred but not required - The Texas 03 Workers’ Compensation license is required - The 08 All Lines License is preferred - 3+ years recent workers compensation claims handling experience required - At least 5 years of workers compensation claims experience preferred - Solid knowledge of workers compensation laws, policies, and procedures - Completion of IEA or equivalent courses - Proficiency in determining case value and negotiating settlements - Understanding of medical and legal terminology - Mathematical calculating skills - Well-developed verbal and written communication skills with strong attention to detail - Excellent organizational skills and ability to multi-task - Ability to type quickly, accurately and for prolonged periods - Proficient in Microsoft Office Suite - Ability to learn additional computer programs - Reasoning ability, including problem-solving and analytical skills - Ability to be trustworthy, dependable, and team-oriented - Seeks to include innovative strategies and methods to provide a high level of commitment to service and results - Ability to demonstrate care and concern for fellow team members and clients - Acts with integrity in difficult or challenging situations Requirements - Must be able to reliably commute to meetings and events as required by this position Benefits - Comprehensive health insurance - 401(k) with company match - Eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments - Variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options - Company-Paid STD & LTD