Claims Operations Associate – Workers Compensation

Job Description:

  • Demonstrates beginner to intermediate knowledge of the claims operations and the ability to address simple requests and complaints received via telephone, email, or voicemail, with some guidance.
  • Performs daily mail pickup, scanning and file functions; sorts and distributes mail & maintains/purges documents according to record retention guidelines.
  • Utilizes the multiple systems to identify the appropriate recipient of correspondence; distributes electronic records accordingly.
  • Expands upon and employs problem-solving skills and learns the investigative methods needed to actively seek information required to resolve inquiries and issues.
  • May learn to execute basic claim setup and entry, coverage verification, and financial transactions.
  • Learns to identify discrepancies in information gathered.
  • Becomes familiar with and utilizes multiple computer systems for policy analysis, claim management, data management, reporting, and productivity.
  • Learns to utilize ClaimExpert, ClaimConnect, ClaimCenter, OpsNow, and Outlook to track workload, manage activities, remain organized, and timely.
  • Refers non-routine/complex issues to manager or more experienced staff.
  • May assist with and/or create general correspondence.
  • Maintains a professional demeanor in all situations.
  • Performs all other duties and tasks as assigned. Works productively under close supervision; relies on instructions and pre-established guidelines to perform the functions of the job

Requirements:

  • High school diploma is required
  • Related billing claims assistant, claims processing or claims operations support experience is required
  • Workers' compensation claims experience is preferred
  • Excellent communication skills in both written and verbal form is required
  • Must be able to work with accuracy and speed with a variety of internal and external contacts
  • Reliable transportation is required

Benefits:

  • medical, dental, and vision coverage
  • wellness plans
  • parental leave
  • adoption assistance
  • tuition reimbursement
  • Paid Time Off
  • paid holidays
  • 401(k) plan with company match
  • employee stock purchase plan
  • commuter benefits
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