Claims Assistant

Location
Orange, California
Salary
Not Specified
Posted
Apr 16, 2018
Closes
Jun 15, 2018
Ref
R1185#GIJ--York.1
Category
Claims
Job Type
Not Specified
Career Level
Not Specified

York Risk Services Group is a premier provider of insurance, risk management, alternative risk, pool administration and claims management solutions to clients across hundreds of industries. Recently named by Forbes as one of "America's Best Midsized Companies 2017" We firmly believe that our employees drive the success of the company. With success in mind as the ultimate goal, we strive to create and provide an environment that offers challenging, stimulating and financially rewarding opportunities.

Job Description

Assists claims examiners by providing clerical support. Responsible for payment of all indemnity payments, processing and payment of all bills, performing all clerical tasks and supporting the supervisor to ensure team is meeting performance standards and procedures.

ESSENTIAL JOB RESPONSIBILITIES:

  • Payment of all indemnity payments and responsibility for ongoing payment as needed, along with creating required DWC notices.
  • Completing all clerical tasks assigned, such as file and serve documents to attorneys, doctors, employees and employers, bill objection letters, litigation referrals, scheduling doctor appointments, requesting records, etc.
  • Processing payment of in house bills timely
  • Fosters a teamwork attitude in the department to include maintaining good relationships with examiners and supervisor, initiative to learn workers comp and offering assistants when daily work has been completed.

OPS RACI RESPONSIBILITIES:

  • Investigations
  • Denials
  • Benefit Delivery
  • Penalties and E&Os
  • Significant Claims Activities
  • Continuous Improvement

SUPERVISORY RESPONSIBILITIES:

SUPERVISION RECEIVED:

  • This position reports to the Unit Manager

SUPERVISION EXERCISED:

  • NA

POTENTIAL ADDITIONAL RESPONSIBILITIES:

  • Responsible for setting up new claims and creating files,
  • Setting up new claims within 1 day, preparing required letters and data integrity in claims system

QUALIFICATIONS:

EDUCATION:

  • BS / BA or Equivalent Work Experience

EXPERIENCE:

  • 1 year

SKILLS/ABILITIES:

  • Must be able to prioritize tasks according to strict timelines
  • Must be able to work alongside claims examiner as a partner as clerical support

KNOWLEDGE:

  • Computer experience Typing at least 45 - 60 wpm, moderate understanding of Word and e-mail programs
  • Moderate customer services skills for phone, email and letter production

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