Insurance Claims Processor
4 weeks ago
As a member of the Customer Service Center Premium Operations Team at PMA Companies, you will play a critical role in ensuring efficient and timely processing of all work assignments into applicable business systems with strict adherence to established procedures to assist in the attainment of service level goals throughout the CSC.
Key Responsibilities:
Attain a level of performance of at least 98.5% quality processing of loss sensitive adjustments.
Handle multiple tasks simultaneously with a focus on continuously attaining team and CSC service levels
Identify and process all tasks within corporate guidelines
Maintain compliance with various bureaus by utilizing internal and external vendor websites and automated systems, and process the following according to published deadlines: ICR's, Test Audits, Monitor NCCI and independent state websites, extract and log reports for team processing
Identify process improvements and relay to supervisor for discussion
Research and resolve issues
Perform a variety of support functions and handle special projects as assigned by Supervisor
Provide team training and support as assigned
Process tasks received in multiple work queues according to established procedures
Demonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.
Required Skills:
- High School Diploma or equivalent
- Strong mathematics aptitude
- Effective verbal and written communication skills both internally and externally
- Understanding of claims and underwriting systems/processes
- Working knowledge of Excel, Word, IWS, Pipeline, Policy Decisions, Hyperion Insight and Brio preparation, Keymaster, Mainframe editing functions, PMA Claim Center including activity assignment and completion, various state WC Bureau websites/requirements
- Experience with WC rating & loss sensitive adjustments
- Attention to detail and quality awareness
- Ability to function independently with minimal technical support
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