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Claims Service Representative
5 months ago
JOB SUMMARY
The Claims Support Representative will perform administrative tasks as assigned by the Claims Manager to support the receipt and processing of claims and payments and provide support to all risk department team members with various tasks as needed. This position will also provide administrative support with answering phone inquiries, receipt and processing of claims documents and records within an electronic environment, safety data entry and reports, processing payments, preparation, and distribution of correspondence, and other clerical/administrative functions under the direction of the Claims Manager.
DUTIES AND RESPONSIBILITIES
- General office and clerical responsibilities, including answering telephones, e-filing, billing reconciliation for various vendors, document gathering for audit purposes, and other duties as assigned.
- Reviews claims estimates loss and expense costs that are received from claimants or third parties. Analyzes, reviews, and adjusts claims valued at less than $1500 for accuracy, completeness and eligibility, consults with Claims Manager or peers for assistance as needed.
- Manage Outlook emails for the Claims Department
- Assists claimants, vendors, and clients with inquiries regarding their claims as needed.
- Supports Claims and data management.
- Processes claim payments for escrow to TPA, Rental Car payments, and other payments as assigned, maintains record of accounts; prepares correspondence and backup information in support of payments and assures they are properly loaded and tracked into the claims management system.
- Assists with data management, coding, and analysis, and prepares various ad hoc, monthly, and annual safety/claims reports as assigned by the Claims Manager.
- Organizes and prioritizes large volumes of information and calls.
- Types of general correspondence, memos, charts, tables, graphs, business plans, etc. Proofreads copy for spelling, grammar, and layout, making appropriate changes. Responsible for the accuracy and clarity of the final copy.
- May Support analysts with reporting claims to insurance carrier/TPA when needed.
- Comply with state laws, policies, and company procedures.
Administration
- Performs administrative support tasks for Risk Management and other members of the Claims Department including but not limited to distribution of various correspondences, phone support, etc.
- Processing of payments as assigned by Claims Manager, and Analysts as needed, data entry and verification of payments, and audit of records.
- Compiles and prepares statistical data and reports under the supervision and direction of the Claims Manager.
- Catalogs and records files for e-storage.
- E-Files claim folders or any other pertinent documents.
KNOWLEDGE, SKILLS AND ABILITIES
- Computer proficiency and technical aptitude with an ability to utilize advanced functions of MS Office (Excel, Word, PowerPoint, Visio, and Outlook), the internet, and various Claims applications and databases.
- Ability to manage several projects simultaneously while working under pressure to meet deadlines.
- Ability to read, analyze, and interpret general business correspondence, instruction guides, and training materials.
- Excellent verbal communication skills to speak clearly and persuasively in positive or negative situations, demonstrates group presentation skills, and participates in meetings.
- Excellent written communication skills to provide any necessary correspondence with internal and external customers.
QUALIFICATIONS
- High school diploma or general education degree (GED); six to twelve months related experience and/or training; or equivalent combination of education and experience. BS preferred.
- Ability to read and interpret documents, insurance claims, and procedure manuals. Ability to write routine correspondence.
- Ability to add, subtract, multiply, and divide.
- Ability to define problems, collect data, establish facts, and draw valid conclusions.
- Ability to interpret an extensive variety of instructions in written or diagram form.
- Skill and ability to use and operate an adding machine, computer, fax machine, scanner, and copier.
- Must have proficient skill and ability to use advanced features of Microsoft Word, Outlook, Excel, PowerPoint, and Visio.
