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Claims Administrator
2 weeks ago
JOB SUMMARY
Provides claims support, data organization and administrative service to Insurance and Claims Department. Maintains and updates claims files and Insurance & Claim System (VICS). Reports directly to and takes direction from the Senior Claims Specialist.
RESPONSIBILITIES
Administrative Support
- Enter data from medical invoices into claims
- Receive, review, file, and/or email various reports and notifications
- Create, scan, copy, file, and/or distribute various documents
- Draft various documents and correspondence
- Support Insurance and Claims Department in litigation and claims management
Claims Processing
- Create and organize claim files
- Maintain and update claim files in VICS
- Assist with claims processing of vessel related damage, oil spill, and injury/illness claims
- Assist with claims processing of land-based employee workers' compensation, automobile, third party, and other claims
- Submit medical claims/invoices for audit with outside vendor, reduce audited claims, complete letter to provider serving as EOB, and submit to accounting
- Assist with data compilation and preparations for submitting claims for insurance reimbursement
- Assist with processing of 'maintenance and cure' payments, wages, along with other financial documentation
- Administer VICS with Insurance and Claims team to capture data needed for enhancements and additional reporting
- Participate in insurance and claims-related meetings
- Interact with vessel crew members, managers, vendors within the context of claims
Insurance
- Gain knowledge of Certificates of Insurance and various other insurance documents and certificates
- Complete applications for various insurance documents and certificates
- Gain knowledge of and utilize various company and industry-specific electronic and/or online resources.
QUALIFICATIONS:
Education & Experience
- 2 plus years related experience working with or knowledge of medical claims
- Military experience is a plus
- Jones Act/General Maritime knowledge/experience is a plus
- Insurance, medical, healthcare industry knowledge/experience is a plus
- Case management experience is a plus
- Associates / Bachelor's Degree is a plus
Knowledge & Skills
- Meticulous attention to detail
- Ability to manage multiple priorities, be a self-starter, clearly communicate in a team environment and with providers and vendors
- Desire to take on increasing responsibilities
- Excellent verbal and written communication skills
- Customer service friendly
- Strong computer experience, especially in Word, Excel and with email
- Experience managing and navigating various websites/database content
- Knowledge of worker's compensation, medical terminology, and insurance preferred
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