Claims Support Services Assistant

San Diego, California

 

The Claims Support Services Assistant on the Workers' Compensation Audit & Compliance team provides basic financial, payment and administrative support to the claims department. The position exists to facilitate efficient operations and a superior customer experience. Each day offers new challenges as you tackle a wide range of tasks.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Handles incoming, outgoing, and return checks as requested.

  • Provides administrative support to claims department including mailing checks issued in-house.
  • Reviews incoming checks to determine appropriate department. Identifies type of payment and coordinates with the examiner to apply the payment to the claim as appropriate.
  • Coordinates with accounting to confirm successful deposit of each check.
  • Researches and investigates return checks and re-sends as appropriate.

Performs payment corrections and resolves payment errors as requested.

  • Obtains appropriate authorization to offset and enter corrected payment transactions per request.
  • Handles payment inquiries from vendors and internal customers.
  • Reviews and resolves payment processing errors.

Performs claim modifications, corrects errors and handles policy notifications as requested.

  • Obtains proper authorization prior to correcting specific claim fields (policy, date of loss, class code etc.).
  • Reviews and resolves claim data integrity errors.
  • Reviews policy endorsement and cancellation notifications to determine the impact to claims.
  • Manages a daily report for all claims opened on the dummy policy and tracks until placed on correct claim.

Reviews Claims data and assists with department initiatives as requested.

  • Performs a daily review and research of potentially late indemnity payments for each jurisdiction.
  • Reviews content of different state forms (website, letters, claim kits) and escalates as appropriate.
  • Reviews re-insurance monthly, including ceding excess losses in the accounting system.
  • Researches, verifies, and enters data into various systems.
  • Updates department iPortal page when requested.

SUPERVISORY RESPONSIBILITIES

This role does not have supervisory responsibilities.

EDUCATION AND EXPERIENCE

High School Diploma or general education diploma (GED) required. Bachelor's degree from a four-year college with a major or emphasis in Business Administration, Accounting, Mathematics, or related field a plus. Minimum 1 year of related experience and/or training; or equivalent combination of education and experience.

CERTIFICATES, LICENSES, REGISTRATIONS

None required.

KNOWLEDGE AND SKILLS

Demonstrated ability in Business Mathematics and administrative processes or other areas involving working with numbers and data. Proficiency in Microsoft Office Suite including Word and Excel. Strong problem-solving ability and critical thinking skills. Ability to research problems and offer solutions.

PHYSICAL REQUIREMENTS

Office environment – no specific or unusual physical or environmental demands and employees are regularly required to sit, walk, stand, talk, and hear.

COMPETENCIES

This position maps to the Individual Contributor level. Additional competencies required: Learning Agility, Organizing & Planning, and Initiative.

WORK ENVIRONMENT

This position operates in an office environment and requires the frequent use of a computer, telephone, copier, and other standard office equipment.

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