Assists claims staff in the administrative functions in reporting of new claims, verification of claim status. May serve as entry level claims adjuster responsible for payment of simple medical only WC and P&C claims. This position is an entry-level technical position and works closely with a Claim Adjuster, Senior Claim Adjuster or a Supervisor.
- Receive loss notices via fax, telephone, or email.
- Set up claims and forward to adjusters
- Maintain appropriate registers
- Complete data entry, check issuance and vouchers, ISO indexing, OFAC indexing
- Maintain policy status information, required logs, and monthly reports
- General clerical duties – i.e. providing support to adjusters by sending faxes, letters, wage statements, contact cards, ordering supplies, etc.
- Determines coverage, compensability and if necessary transfers claim
- Utilizes appropriate preferred vendors
- Processes medical payments
- Must have basic knowledge of current principles and practices associated with claims investigations
- Must be able to understand oral and written policies, procedures or instructions
- Ability to handle confidential medical information
- Obtain licenses where required
- May include other assigned duties
REQUIRED KNOWLEDGE, SKILLS AND ABILITIES:
- Ability to understand and follow oral and/or written policies, procedures and instructions
- Ability to perform a wide variety of duties and responsibilities with accuracy and speed, while meeting time-sensitive deadlines
- General knowledge of claims and ability to identify claims of urgent priority
- Must have good oral and written communication skills
- Excellent telephone and customer service skills
- Ability to use standard or customized software applications appropriate to assigned tasks- Must have a good working knowledge of Excel
- Ability and willingness to learn new skills and knowledge brought about by rapidly changing information and/or technology
Prefer to have 2-5 years experience in claims office or equivalent business experience. Should have basic knowledge of insurance coverages. Must have high school diploma or equivalent.