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Claims Processing Specialist
2 months ago
Overview:
At CCMSI, we seek talented individuals to become part of our professional team.
As a prominent Third Party Administrator in self-insurance services, we are driven by a shared commitment to providing outstanding service to our clients.
Being an Employee-Owned Company, we prioritize the growth of our employees through structured career development initiatives, recognizing and rewarding both individual and team contributions.
Certified as a Great Place To Work, our employee satisfaction and retention rates are in the 95th percentile.Reasons to consider a career with CCMSI:
Culture:
Our Core Values are deeply integrated into our culture, emphasizing the importance of treating our employees as valued partners—with integrity, passion, and enthusiasm.
Career Development:
CCMSI provides comprehensive internships and internal training programs to facilitate advancement within our organization.
Benefits:
Our benefits package includes 4 weeks of paid time off in your first year, along with 10 paid holidays. Additional benefits encompass Medical, Dental, Vision, Life Insurance, Critical Illness, Short and Long Term Disability, 401K, and ESOP.
Work Environment:
We are committed to fostering an environment where employees look forward to coming to work each day, equipped with the necessary resources to perform their roles effectively, and where claims staff manage reasonable caseloads.
We are in search of a meticulous and dedicated Claims Processing Specialist for an in-office role, operating Monday through Friday, from 8:00 AM to 4:30 PM.
The Claims Processing Specialist will be tasked with opening mail, scanning documents, answering phones, entering data, and executing various administrative duties to support our team of workers' compensation adjusters.
The ideal candidate will possess prior experience in the workers' compensation or insurance sector, along with strong attention to detail, multitasking capabilities, and a commitment to accuracy.
The Claims Processing Specialist will perform general clerical duties for the claims personnel and other team members as assigned.This role is vital in ensuring the quality of claim service as perceived by CCMSI clients and maintaining adherence to Corporate Claim Standards.
Responsibilities:
Match incoming mail to assigned accounts.
Follow up on outstanding bills.
Organize claim mail and related documents.
Establish designated claim files and complete all setup instructions as requested.
Provide backup support for the Receptionist.
Summarize correspondence and medical records in the claim log notes and file them in the appropriate claim, as directed by claim staff.
Maintain claim files in storage.
Photocopy claim documents as necessary.
Return provider calls or other inquiries as directed.
Support claim staff on client-specific teams.
Ensure compliance with service commitments established by the team.
Perform other duties as assigned.
Qualifications:
To succeed in this role, an individual must be able to fulfill each essential duty satisfactorily. The requirements listed below represent the knowledge, skills, and/or abilities necessary.
Excellent oral and written communication skills.
Proactive in setting and achieving performance goals.
Ability to manage job pressures in a dynamic environment.
Knowledge of all lower-level claim position responsibilities.
Must be detail-oriented and a self-starter with strong organizational skills.
Ability to coordinate and prioritize tasks effectively.
Flexibility, accuracy, initiative, and the ability to work with minimal supervision.
Discretion and confidentiality are essential.
Reliable and predictable attendance during client service hours is crucial for this position.
Responsive to the needs of internal and external clients.
Ability to communicate clearly, both verbally and in writing, with internal and external stakeholders.
Education and/or Experience
A High School diploma or equivalent is required.
Computer Skills
Proficient in Microsoft Office applications.
Certificates, Licenses, Registrations
No specific certifications required.
CORE VALUES & PRINCIPLES
Responsible for upholding the CCMSI Core Values & Principles, which include: performing with integrity; passionately focusing on client service; embracing a client-centered vision; maintaining contagious enthusiasm for our clients; seeking the best ideas; viewing change as an opportunity; insisting on excellence; fostering an atmosphere of excitement, informality, and trust; focusing on the situation, issue, or behavior rather than the person; maintaining the self-confidence and self-esteem of others; cultivating constructive relationships; taking the initiative to improve processes; and leading by example.
CCMSI is an Affirmative Action/Equal Employment Opportunity employer offering an excellent benefits package, including Medical, Dental, Vision, Prescription Drug, Flexible Spending, Life, ESOP, and 401K.
