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Handles complex Vermont workers’ compensation claims, including coverage confirmation, compensability investigations, reserves, payments, subrogation, litigation, settlements, recoveries, and regulatory filings. Coordinates return-to-work efforts and collaborates with case managers, attorneys, customers, claimants, and carriers. Maintains claim documentation, communicates claim status, manages action plans to control costs, follows applicable regulations, and supports claims team development.

Supports multi-state leave and accommodation programs, maintains the LOA system, manages HR and Leaves inboxes, responds to employee inquiries, and coordinates communications. Provides administrative support to the VP of HR, prepares reports and presentations, assists with team events and training, and handles confidential HR matters while managing multiple priorities remotely.

Supervise hospital bill audit nurses, ensuring accurate audits and compliance with regulations. Foster team collaboration and handle auditor inquiries while maintaining productivity standards.

The Appeals Representative analyzes appeals in accordance with policies and guidelines, communicates with providers, and ensures timely completion of appeals while adhering to industry standards.