Claims Administrator

2 weeks ago


Baltimore, Maryland, United States Chesapeake Search Partners Full time

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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