ESIS Senior Claims Assistant

The Claims Assistant provides critical administrative and operational support for the Workers Compensation and Risk Management team at the Mashantucket Pequot Tribal Nation/Foxwoods Casino. This role is responsible for intake coordination document management and customer service ensuring efficient claims processing and compliance with Tribal and regulatory requirements.

Key Responsibilities:

• Greet visitors answer the door and direct individuals to ESIS Risk Management Onsite Clinic Physical Therapy or HR Benefits offices.
• Screen newly injured employees and coordinate intake determining assignment to adjuster or Medical Only.
• Contact departments to confirm light duty accommodations for employees.
• As Light Duty Coordinator:
  • Meet with injured employees to review program and assign suitable light duty jobs based on restrictions.
  • Escort employees to assigned positions and maintain ongoing communication to ensure compliance.
  • Track and submit weekly time sheets for light duty employees to payroll.
• Authorize prescriptions with Tribal Pharmacy for injured employees as directed by the Onsite Clinic.
• Meet daily with Clinical Coordinator to review and follow up on physical therapy MRI and care transfer authorizations.
• Coordinate with One Call Medical for MRI/EMG requests on claims.
• Index and manage daily medical reports.
• Complete and distribute First Report of Injury forms maintaining records for OSHA log completion.
• Scan index and organize medical and therapy reports ensuring timely correspondence in WorkView system.
• Process and pay American Ambulance and Tribal Pharmacy bills locally including monthly report indexing and scanning.
• Index hearing dockets prepare files for hearings and print necessary documents.
• Register all claims and complete clerical instructions assigned.
• Perform mailroom duties including postage opening and indexing mail.

• High school diploma or equivalent required; associates degree preferred.
• Prior experience in claims risk management or medical office administration strongly preferred.
• Strong organizational skills and attention to detail.
• Excellent communication and customer service skills.
• Proficiency with document management systems and Microsoft Office Suite.
• Ability to handle confidential information with discretion.