Claims Processing Administrative Coordinator

2 weeks ago


Jacksonville, Florida, United States The Doctors Company Full time

The Doctors Company is looking for a Claims Processing Administrative Coordinator to enhance our operational team.

In this role, you will be responsible for guiding members and callers to gather essential documentation required for establishing an electronic claims file. Additionally, you will provide clerical and technical support to the designated claims personnel. Your duties will include maintaining precise, timely, and accurate coding and file updates to facilitate data warehouse searches for claims processing and research initiatives. You will interact with various stakeholders, including employees, member physicians, agents, brokers, vendors, defense attorneys, administrators, and patients. This position operates under direct supervision.

Qualifications

  • A Bachelor's degree or an equivalent combination of education and experience is required.
  • Experience in the insurance or healthcare sector is preferred.
  • Exceptional oral and written communication abilities.
  • Demonstrated organizational skills and meticulous attention to detail.
  • Strong customer service aptitude and the ability to thrive in a high-performance team environment.
  • Capacity to adhere to departmental procedures with a high degree of accuracy.
  • Aptitude for prioritizing tasks to meet critical deadlines.
  • Ability to manage confidential personal health information in compliance with company policies.
  • Skill in supporting diverse internal and external stakeholders.
Responsibilities

Collaboration & Support for Internal/External Customers
  • Engage with insured members professionally to achieve optimal outcomes.
  • Interact with both internal and external customers proactively.
  • Utilize internal resources for effective problem resolution.
  • Collaborate actively within the claims department and across other departments to enhance customer engagement.
  • Assist internal and external stakeholders throughout the claims process.
Claims Documentation and Management
  • Maintain a comprehensive understanding of company standards and guidelines.
  • Clearly communicate guidelines to stakeholders as needed.
  • Strive to meet expected company and departmental standards.
  • Exercise sound judgment in applying guidelines to achieve desired outcomes.
  • Monitor and authorize fees and expenses in accordance with company and state regulations.
  • Assess attorney performance and inform supervisors of any necessary corrective actions.
Member Services
  • Deliver clear communication to members and follow up as required.
  • Stay attuned to members' needs and the context of their communications.
  • Escalate member concerns to management when necessary.
  • Produce high-quality work that supports efficient downstream workflows.
Policy Development and Compliance
  • Adhere to all established policies and procedures within the service team.
  • Identify and elevate areas for potential improvement and service enhancements.
  • Actively address compliance issues as identified by management.
Additional Duties
  • Contribute to process improvement projects and initiatives.
Salary Range: $47,901 - $59,172

Compensation is determined based on skills, knowledge, and educational background. We consider factors such as specialized skills and depth of knowledge to ensure equitable and competitive pay.

Benefits:

The Doctors Company provides competitive compensation, incentive bonus plans, outstanding career opportunities, and an exceptional work environment, along with a comprehensive benefits package that includes medical, family, and bereavement leave; same-sex domestic partner benefits; short- and long-term disability programs; and an employee assistance program. Additional benefits include:
  • Health, dental, and vision insurance.
  • Health and dependent care tax-free spending accounts with company matching.
  • 401(k) and Roth IRA with company matching, including catch-up plans.
  • Paid vacation, sick days, and personal days each calendar year (with vacation increases based on tenure).
  • 11 paid holidays annually.
  • Life and travel insurance.
  • Tax-free commuter benefits.
  • In-person and online learning opportunities.
  • Cross-functional career opportunities.
  • Business casual work environment.
  • Time off for volunteering.
  • Matching donations to qualifying nonprofit organizations.
  • Company-sponsored participation in nonprofit events.
About The Doctors Company

The Doctors Company is the largest physician-owned medical malpractice insurer in the nation. Founded and led by physicians, we are dedicated to advancing, protecting, and rewarding the practice of quality medicine.

The Doctors Company is proud to be Certified™ by Great Place to Work.

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