DEPARTMENT: CLAIMS
REPORTS TO: CLAIMS PAYABLE SUPERVISOR
STATUS: NON-EXEMPT
REQUIREMENTS:
College degree in Accountancy, required. Detail oriented, organized self-starter with a desire for career development within the insurance industry. 1-2 year's relevant claims processing experience in the workers' compensation field. Medical bill coding experience a plus.
JOB SUMMARY:
Independently process claim payables for Medical Only Adjusters up to $1,500 (one-thousand five-hundred dollars). General knowledge of the controlling state workers' compensation law is required as it pertains to payable processing. Payables are processed/approved under applicable policy coverage and an analysis is completed specific to compensability and processing review. The processing review analysis is documented in the imaged record and tracked in chronological order for future reference. Medical records will be requested by the CPA at the time of bill review, if not contained in the imaged file. Bill processing inquires should be directed to the Claims Payable Analyst. Regardless of the amount, the CPA does not have authority to approve a lump sum settlement payable, however may process after the assigned Analyst has marked with an approval. Support functions include: bill review batching, bill data entry, vendor update/approval request, medical deductible billing, time and expense billing, category reserve changes, task to file handler upon insufficient reserves, check voids, stop payment requests, check distribution and all other duties as assigned.
SKILL AND ABILITY PROFILE:
This individual will possess excellent written, communication and organizational skills, be a good listener, have the ability to multi-task, and stronghold the understanding of human nature and motivation principles. The candidate will readily control/handle problem issues in times of stress, and/or in a climate of conflict or adversity. This individual will adhere to the code of ethical conduct and recognize the importance of practicing fair claims practice in accordance with the workers' compensation law. Must be able to type 45 WPM and have computer literacy; familiarity with Microsoft Word, Excel, Outlook, PowerPoint and imaging systems a plus. Responsiveness to changing business or customer needs.
If interested, please send resume and cover letter with salary requirements to:
