Claims Analyst I

1 week ago


Rockford, Illinois, United States Allied National, Inc Full time
Job Summary

We are seeking a highly skilled Claims Analyst I to join our team at Allied National, Inc. As a Claims Analyst I, you will be responsible for processing claims in a production environment, making decisions on claims reviewed, and communicating with agents, insureds, providers, and other external customers.

Key Responsibilities
  • Enter data into the computer system, meeting departmental standards.
  • Review correspondence to determine if requested information has been received.
  • Make necessary modifications or corrections to the insured's claim file on the computer.
  • Review and process claims within established department guidelines and standards.
  • Access computer system and review policy and benefit information for each claimant.
  • Make appropriate contact with external sources to obtain necessary information to process the claim.
  • Be knowledgeable of all claims procedures, benefit structures, basic policy provisions, guidelines, state riders, telephone procedures, and equipment through initial and ongoing training.
Requirements
  • High school graduate or equivalent.
  • One year of office experience.
  • Medical claims processing experience is strongly preferred.
  • Knowledge and understanding of medical terminology are preferred if none must complete a medical terminology course within six months.
  • Ability to speak, read, comprehend and follow written and verbal English instructions.
  • Ability to communicate effectively verbally and in writing.
  • Ability to compose proper business correspondence.
  • Ability to communicate in an assertive but positive manner.
  • Demonstrated decision-making abilities.
  • Ability to perform basic math skills.
  • Ability to operate a ten-key calculator and have experience with computers and typing at industry minimums.
  • Ability to meet company attendance requirements.
  • Ability to sit or stand for 7.5 hours per day.
  • Ability to achieve department training standards.
  • Ability to achieve and maintain department quality and production standards.
  • Ability to work under and handle the stress associated with varying workloads and deadlines.
Working Conditions

The position requires the ability to assess a problem and analyze the facts to reach appropriate claims decisions. Communication and interpersonal skills are necessary, as the position requires telephone contact and written correspondence with internal and external customers.

The applicant must possess a positive attitude, be resilient, and adapt to a changing work environment within the department and organization.


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