Claims Intake Specialist

4 days ago

Albuquerque, New Mexico, United States New Mexico Mutual Full time
Job Title: Claims Intake Specialist

At New Mexico Mutual, we are seeking a highly organized and detail-oriented Claims Intake Specialist to join our team. As a Claims Intake Specialist, you will play a critical role in ensuring the smooth operation of our Claims Department.

Key Responsibilities:
  • Perform data entry of new First Reports of Injury information received by phone or other method.
  • Provide limited claim instructions or information to customers; direct complex inquiries to appropriate Claims Adjusters for response.
  • Contact insured or other involved persons to obtain missing claim information.
  • Sort, scan, classify, code and perform data entry of incoming documents and information for integration into software systems.
  • Prepare and scan documents into the imaging system. Provide quality assurance for all documents scanned.
  • Support the claims adjusting staff with billing issues, problems and disputes. Coordinate response to these providers from our bill review vendor.
  • Maintain records, reports, and/or files.
  • Copy and organize large volume files for transmission to legal counsel or others as appropriate.
  • Obtain W9 documents for new or changed provider address book contact according to established procedures.
  • Monitor the medical bill holds in the bill review vendor system. Notify the appropriate staff to receive direction related to these bill holds.
  • Sort incoming mail and packages. Deliver to appropriate Adjusters.
  • Serve as back-up for claims administration duties within the Provider Relations Department.
  • Other related duties as assigned by supervisor.
Requirements:
  • Bilingual in English and Spanish. Fluency in oral and written communication.
  • Excellent customer service skills with ability to communicate professionally with stakeholders.
  • Strong attention to detail and focus on accuracy.
  • Positive attitude and willingly collaborates in a team environment.
  • Ability to organize and prioritize work.
  • Intermediate computer skills and ability to learn new computer applications.
  • Ability to meet deadlines and respond well to direction.
Working Conditions:
  • New Mexico Mutual maintains general office conditions with light physical demands.
  • Employees of New Mexico Mutual adhere to all safety rules and regulations including building security.
  • Employees participate in ensuring safe and efficient operating conditions that safeguard employees and facilities.
  • New Mexico Mutual maintains a drug-free environment, drug testing prior to employment as well as upon a work-related accident.
  • Exposure to VDT screens.

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