COMPETENCIES / QUALIFICATIONS
- Professional telephone demeanor, good verbal and written communication skills, good listening skills, along with strong organizational skills.
- Thorough knowledge of workers’ compensation claims procedures and policies.
- Possess a strong understanding of human nature and motivation principles.
- Readily control/handle problem issues in times of stress and in a climate of conflict and/or adversity.
- Computer literacy including strong familiarity with Microsoft Office Suite. Ability to type 45 WPM.
- Basic understanding of business technology.
- Responsiveness to changing business needs.
- Ability to work well under pressure and multi-task in a fast paced environment while continually paying attention to detail.
- Ability to adhere to the code of ethical conduct.
- Ability to take direction and make decisions.
- Ability to learn new procedures quickly and adapt to a changing environment.
- Ability to work in a team environment.
- Ability to work with limited supervision.
ESSENTIAL FUNCTIONS
- Performs data entry functions (claim file updates, forms, form letters, electronic interfaces, etc. ) as required.
- Completes 10 day, and 6 month claim maintenance tasks in a timely manner.
- Reviews and completes FROI/SROI, class code and CMS corrections.
- Oversees the handling and submission of Manual FROI/SROI and manual state form submissions.
- Reviews corrections in conjunction with Compliance for Unit Statistical Reporting.
- Performs general maintenance of claims documents in both ImageRight and Powersuite.
- Completes closure of all claim files as submitted by Supervisory personnel.
- Assists with record subpoena and utilization review submissions.
- Completes lien reviews and vendor referrals.
- Assists claims analysts as needed.
- Other duties and projects as assigned.
EDUCATION / EXPERIENCE REQUIREMENTS
- Minimum Education: High School Diploma or equivalent.
- Preferred Education: College degree preferred.
- 1-2 years of relevant claims processing experience preferable in the worker’s compensation field or similar experience.
- Desire for career development within the insurance industry.
Job Type: Full-time
Pay: $16.00 - $17.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Health insurance
- Life insurance
- Paid time off
- Referral program
- Vision insurance
Schedule:
Work setting:
Education:
Experience:
- Administrative: 1 year (Preferred)
- Customer service: 1 year (Preferred)
Work Location: In person