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Workers Compensation Claims Management Services
Orion serves as your expert in managing the claims process in the most effective way to benefit your organization. Our claims management specialists begin the process by determining if the claim is compensable or if it needs investigation. Then, we create the most effective action plan so the injured employee is returned to work as soon as possible. On denied claims, we work closely with the adjuster to structure a strong defense and minimize the financial impact of each claim.
Orion’s claims services may include the following:
- Work with the adjusters to establish and maintain an action plan to manage each open claim
- Consistently manage all open claims by working with the claims adjusters at each critical point in the claims process when something can be done.
- Facilitate the timely communication of critical information and make sure it is properly acted upon.
- Communicate with the adjuster and client to fully investigate suspicious claims in order to manage the legitimate claims and fight the fraudulent ones.
- Negotiate with the adjusters to reach the quickest possible claim resolution on every claim and ensuring that it is in the client’s best interests.
- Work with the adjuster to minimize the reserves on open claims.
- Review the experience modification worksheet for accuracy by making sure incurred claim values are not overstated and payroll values are fully listed.
- Estimate the experience modification after Unit Stat reporting for business planning purposes.
- Audit closed files for factors that may improve the experience modification and future premiums.
- Provide training to the client on workers’ compensation theory and claims handling to facilitate understanding of the claims process.
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