Claims Clerk Ii Job Description Sample
Disability Claims Clerk II
AmTrust North America, a Fortune 500 company, is looking for a disability claims clerk II for their office in Jersey City. The claims clerk II performs all clerical functions related to DBL Claims according to departmental methods and procedures.
Basic knowledge of Microsoft Office.
Minimum of two years clerical experience.
Typing and mathematical skills.
Excellent analytical skills.
Good verbal and written communication skills.
Good customer service skills.
Able to handle a large volume of work accurately.
Completes tasks within allotted time frame.
Ability to work independently without close supervision.
Monitor incoming faxes on Fax to Server.
Open mail, search, sort, prep, scan, index and route to the examiners inbox.
Prepare and index daily correspondence and route to the Examiners inbox.
Set-up new claim and route to the Examiners inbox.
New claim (DB450), search and verify coverage.
Type various letters and forms.
Input data on various logs.
Answer incoming calls.
Make call to Employer for policy number.
Prepare DB120.1 requests, scan, email or fax completed forms to the insureds
- Performs miscellaneous duties as necessary
Multiple concurrent tasks
Sitting or Standing
What we offer:
AmTrust Financial Services offers a competitive compensation package and excellent career advancement opportunities. Our benefits include: Medical & Dental Plans, Life Insurance, Health Care Flexible Spending, Dependent Care, 401k Savings Plans, Paid Vacation and Holidays.
Warranty Claims Clerk
MPP Company, as a leader in the industry, provides a comprehensive selection of extended warranty services and other automotive protection plans designed to give our customers the best buying and ownership experience. We provide vehicle service contracts (frequesntly referred to as extended warranties), maintenance contracts, paintless dent repair, lease wear coverage and more.
Receive documents in from dealers and customers
Check email folders on a regular basis for incoming documents to import into scanning software
Index documents to the correct department for processing
Contact customers / dealerships concerning payable issues
Other duties may be assigned
Strong keyboard skills including 10 key
Minimum high school diploma or GED equivalent required
Excellent customer service skills, underwriting background a plus
Ability to be analytical and multi-task
Ability to work with little supervision
Self-motivated, enthusiastic presence in a team environment
Strong written and communication skills
Working knowledge of Microsoft Office
Consistent and stable work history
Valid driver's license and clean driving record
Professional appearance and work ethic
All potential employees must pass pre-employment testing to include a background check and drug screen.
Competitive earning and overtime potential
Fast paced work environment
Paid training and development
Career growth opportunities with management potential
Medical and dental coverage available 2 month period
8500 Shawnee Mission Parkway
Merriam, KS 66202
Compensation: $14 - 15/ HR
Claims Clerk - Wausau, WI
Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.
The Claims Clerk is responsible for providing expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims.
Provide general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims
Authorize the appropriate payment or refers claims to investigators for further review
Conduct data entry and re - work; analyzes and identifies trends and provides reports as necessary
Analyze and identify trends and provide reports as necessary
Consistently meet established productivity, schedule adherence, and quality standards
Recognize claims by determining claim type
- HCFA, Hospital, UB, and / or RX
Identify more complicated claims and refer them to Senior Claim Processor or Supervisor
Calculate other insurance and re - pricing benefits
Work claims files to ensure the appropriate eligibility and provider records are matched to the claim.
Updates and maintains claims tracking database
Limited work experience
Works on simple tasks using established procedures
Depends on others for guidance
Work is typically reviewed by others
High School Diploma / GED (or higher)
1 years of experience in an office setting environment using a computer as the primary instrument to perform job duties
1 years of experience managing with multiple tabs within Internet Explorer in a work environment
Ability to work 8:00 am
4:30 pm for training and 7:00 am
5:00 pm (8 hours) after training
Prior experience working with Medical Claims
Ability to type 60 WPM
Proficient with 10 key numeric pad data entry
Experience in production based environment
Understanding of Healthcare Claims including ICD-10 and CPT codes
Physical Requirements and Work Environment:
- Extended periods of sitting at a computer and use of hands/fingers across keyboard or mouse
Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of healthcare. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Keywords: customer service representative, customer service, CSR, UnitedHealth Group, call center, UnitedHealthcare, health care, office, phone support, claims clerks, Wausau,WI , medical claims , healthcare claims
National Claims Support Clerk
Infinity Insurance Company is a leader in bringing specialized automobile insurance programs to the marketplace. We deliver innovative products and services that are designed to meet the diverse and evolving insurance needs of consumers.
When we named our company "Infinity" we knew it was a bold title. Infinity means without end.
For more than 50 years, Infinity has done justice to its name, searching for every possible way to offer the best service. The key to our ongoing success is excellence. We strive for excellence in every detail, from our policy offerings and insurance products to our hiring and training programs.
We don't take excellence for granted. All of our hard work has paid off. We consistently outperform the industry by making auto insurance more accessible, easier to understand and affordable.
ABOUT THIS POSITION
In this role, you'll assist callers with general question about their claims and/or take and forward messages as appropriate.
Answer general customer inquires on claims procedures
Provide prompt and friendly service at all times
Enter claim notes
Requires typing skills of 20WPM with 95% accuracy. Must be familiar with general office equipment.
Good verbal and written communication skills are a must. One year clerical experience in a similar role required.
Employees understand our commitment to a positive work environment and dedication to the utmost in service. Advancement opportunities include skill training and career paths for many positions. We take the time to get to know our customers and recognize the importance of building long-term relationships – with our business clients as well as our hardworking employees.
Come see why our team gets the job done right and has fun doing it!
Claims Adjuster II
Marriott International is the world's largest hotel company, with more brands, more hotels and more opportunities for associates to grow and succeed. We believe a great career is a journey of discovery and exploration. So, we ask, where will your journey take you?
A Claims Adjuster II is responsible for the timely, good faith adjustment and disposition of self-administered casualty claims in multiple jurisdictions. Responsibility extends to all aspects and phases of investigations, evaluations, negotiations and settlements/denials of the following claims: workers' compensation, auto liability, no-fault uninsured motorist and general liability.
SCOPE/BUSINESS CONTEXT/EXPECTED CONTRIBUTIONS
Manage 100-150 casualty claims on assignment.
Acceptable caseloads vary based on the jurisdiction(s), mix and complexity of Worker's Compensation and General Liability cases as determined by Claims Unit Manager.
Investigate claims promptly – taking statements as necessary – to determine liability/compensability.
Evaluate damages and pay benefits as prescribed by law and/or Marriott policies and procedures.
Secure necessary documentation to facilitate timely loss adjustment and maintain primary responsibility for settlement decisions up to individual authority.
Complete and monitor timely WC payments/state filings.
Monitor and actively manage WC medical treatment with the goal of minimizing disability. Consult Occupational Health Services as necessary.
Manage litigation cases including controlling/directing outside attorneys, assisting in discovery/trial preparation and strategy.
Evaluate claims for potential third party or subrogation recovery.
Participate in the Service Call Program and complete required Service Call reports detailing current case status.
Actively participate in regularly scheduled unit meetings and department meetings.
Comply with Marriott Casualty Claims Policy and Procedure Manual requirements.
Effectively utilize the Valley Oaks System (iVOS) to manage all claims electronically.
Enter action plan notes/website notes into iVOS.
Participate in activities that foster teamwork and continuous quality improvement.
- Minimum of 18 months claims adjusting experience.
Knowledge and Skills
Ability to grasp and apply technical knowledge, including litigation case management and adjusting skills.
Effective reasoning, analysis and decision making skills.
Effective influence skills.
Strong negotiation skills.
Strong organization skills.
Strong hospitality skills.
Demonstrate strong leadership abilities.
Ability to prioritize work.
Ability to meet deadlines and follow up in a timely manner.
Good communication skills (verbal, listening, writing), including the ability to deliver difficult messages to customers and/or claimants.
Good investigation skills.
Basic knowledge of claims process.
Strong computer skills.
Ability to work well in a team, providing assistance to fellow associates and representing the mission of the unit.
Possess a willingness to accept and respond positively to constructive criticism.
Present oneself with a positive, professional demeanor.
Communicate often with supervisor keeping him/her informed.
Education or Certification
High School Diploma or GED preferred.
Two or four year degree from an accredited college/business/technical school preferred.
Applicable industry licensing.
Associate in Claims or Associate in Risk Management preferred.
Marriott International is an equal opportunity employer committed to hiring a diverse workforce and sustaining an inclusive culture. Marriott International does not discriminate on the basis of disability, veteran status or any other basis protected under federal, state or local laws.
Healthcare Claims Mailroom Clerk
DXC Technology (NYSE: DXC) is the world's leading independent, end-to-end IT services company, helping clients harness the power of innovation to thrive on change. Created by the merger of CSC and the Enterprise Services business of Hewlett Packard Enterprise, DXC Technology serves nearly 6,000 private and public sector clients across 70 countries. The company's technology independence, global talent and extensive partner alliance combine to deliver powerful next-generation IT services and solutions. DXC Technology is recognized among the best corporate citizens globally. For more information, visit www.dxc.technology.
The Insurance/Healthcarejob family contains positions associated with providing consultancy utilizing knowledge and expertise on insurance and healthcare. Develops and implements general insurance and health policies in accordance with state and federal laws. Provides expertise to investigate and adjudicate claim characteristics that do not match policy provisions. Responds to provider appeals and meets with providers to resolve problems/issues. Provides directions for utilization review. Approves any remedial or recoupment actions associated with escalated claims. Advises provider review councils, state officials and works with organized healthcare groups and associations on various medical issues related to insurance and healthcare programs.
Participates productively as member of team, possibly in a team lead role.
Completes complex tasks, assignments and defined processes with some level of independence.
Multiple assignments worked and completed simultaneously as directed by leadership.
Identifies, prioritizes and resolves most questions and issues independently. Answers questions of peers. Escalates more complex questions or issues appropriately.
Complies with contract requirements, business unit rules and related industry and legal regulations
Education and Experience:
High School Diploma or equivalent; may hold 2 year post-high school Degree
Typically, 2-4 years of working experience in related fields.
Knowledge and Skills:
Claims and healthcare knowledge preferrd
Office administrative experience and skills.
Ability to follow written policies, procedures and guidelines, and give feedback to leadership.
Intermediate-level knowledge of operating systems.
Self-motivated with good time management and organizational skills.
Ability to read and interpret basic to moderately complex documents such as operating and maintenance instructions, procedure manuals, and government/healthcare guidelines.
Excellent written and verbal communication skills and customer service skills, including professional telephone skills.
EEO Tagline: DXC Technology is EEO F/M/Protected Veteran/ Individual with Disabilities
Claims Appeals Clerk
Morgan Stephens represents the nation’s top healthcare systems offering the highest compensation and benefits to our top candidates. We are created and managed by experienced industry professionals in healthcare. As a leading provider of contract, contract to perm, and direct placement recruiting services to healthcare organizations throughout the United States, we have successfully served the needs of our employees and clients by placing thousands of quality healthcare professionals into organizations seeking top talent.
Exciting opportunity for career growth for a healthcare administrative professionals with any background in claims!
Details: printing letters, printing envelops, getting them stamped, making copies of the letter, and creating files for member compliance and appeals. Putting information into the system for documentation purposes and completing jobs that have a deadline.
Attention to detail
Ability to meet deadlines and work under pressure
Strong communication skills.
Professional clerical experience or data entry experience
35+ WPM score
Morgan Stephens ofrecemos reclutadores que hablan Espanol
Life Claims Clerk (11462)
The claims clerk job is to receive and prep mail for the incontestable and contestable life claims units. Claims clerks are to make sure that the proper paper work is included in the received mail since different pieces of mail are needed to process a claim depending if it is incontestable or contestable. If the proper paper work is missing the claims clerk will request a systematic letter to request the needed information. The claims clerk also prepares follow up letters to the beneficiary. If no additional information is needed, the mail is sent to its respective department. The claims clerk also updates information in the system with regards to claim status. Claims clerks perform a variety of other functions which can include; match medical records to files, match contestable claim correspondence to files, working pending proof reports, follow up on all claim in suspense and follow up on reconciling items received from accounting.
Requests additional missing information to process claims.
Updates the system with current status of claims.
Matches medical records to files.
Matches contestable claim correspondence to files.
Researches all claims in suspense status.
Researches reconciling items received from Accounting.
Works pending proof reports.
Maintains production records of work performed and must meet the minimum production quotas set by the department.
Other duties; as requested by the supervisor.
Must be pc/Windows literate and posses a working knowledge of MS Office (Outlook, Excel and Word).
Data entry and 10-key skills by touch and sight.
High School Diploma or GED equivalent.
Job LocationOklahoma City, Oklahoma, United StatesPosition TypeFull-Time/Regular
Commercial Claims Examiner II - Icat
The Claims Examiner II adjusts property and catastrophe claims as well as provides a full range of claims support and customer service for all of Boulder Claim's operations. The Claims Examiner II will work closely with the Claims Manager, Claims Assistant, Large Loss Specialist and Independent Adjusters to ensure smooth transition of claims files through the workflow process.
To perform this job successfully, an individual must be able to perform each essential responsibility satisfactorily.
Provides a full range claims adjustment duties. Duties include, but are not limited to:
Evaluate estimates and inspections.
Apply coverages on Boulder Claims' losses.
Review and analyze reports from independents, experts and vendors.
Prepare for negotiation or settlement of assigned claims.
Prepare claim payments within established authority.
Works within operating systems, policies and procedures that achieve the directives of the strategic plans of the business unit and company.
Negotiates with insureds, public adjusters, attorneys, and other parties representing ICAT insureds.
Prepares reports on assigned claims.
Provides feedback on claims procedures and processes.
Participate in ICAT underwriting quality and claims reviews.
Participate in Boulder Claims' Large Loss meetings as needed.
Where appropriate, attend internal and external training and seminars.
Where appropriate, perform claim closings and re-openings on files.
Support project manager including, preparation of documents, and follow-up on timelines and deliverables.
Attend project meetings and prepare meeting minutes and action items.
Participate on cross-functional teams.
Maintain knowledge of and support ICAT's company values and strategic plan.
Sit or stand and work at a computer keyboard for extended periods of time.
Stoop, kneel, bend at the waist and reach.
Work is generally scheduled Monday through Friday with some evening, weekend and holiday hours.
Perform general office administrative activities, including copying, filing and using the phone.
Able to lift up to 25 pounds occasionally.
Additional duties as assigned.
Preferred Job Qualifications
Bachelor's degree in insurance, business or related field or equivalent experience.
Three to five years commercial property and/or catastrophe claims examination processing experience or related insurance experience.
Adjusters License for a minimum of Texas and Florida. Able to obtain reciprocal licensing where required for the business and approved by the state.
At ICAT, we have a single goal: help business owners and homeowners recover from a disaster. Since 1998, ICAT has provided catastrophe insurance coverage to home and business owners throughout the United States. From day one through today, we remain a highly specialized, disciplined underwriter of catastrophe property insurance risk.
ICAT has over 200 employees and serves more than 65,000 customers in 42 states through its online quoting system, www.icat.com and through traditional broker submissions. The ICAT brand offers the promise of "Security, Service, Recovery" to policyholders and brokers in providing insurance solutions to protect against natural catastrophe events. ICAT continues to expand through new products such as its Residential Earthquake product in California, which helps homeowners protect their largest asset in the event of an earthquake.
ICAT underwrites on behalf of a diverse line up of strong carrier partners and Lloyd's of London syndicates. Claims administration services are provided by ICAT's sister company Boulder Claims. Boulder Claims was founded in 2005 and in its short history has successfully adjusted and settled over 23,000 claims, including claims from Hurricanes Charley, Frances, Ivan, Jeanne, Katrina, Rita, Wilma, Dolly, Gustav and Ike. ICAT is based in Broomfield, CO with additional offices in Tampa and Honolulu.
ICAT is owned by The Schinnerer Group. The Schinnerer Group is one of the largest and most experienced underwriting managers of specialty insurance programs in the world. The Schinnerer Group includes Victor O. Schinnerer & Company and ICAT in the United States, ENCON in Canada and other MGA enterprises globally. For more information on ICAT, visit us at: www.icat.com.
Pended Claims Coordinator II
Position Purpose: Review and price pended claims as a result of high dollar limits or system errors.
Assists with financial projects related to claims. Produce claims reports for department. Develop Process Bulletins for the Claims staff on claims processing instructions.
Run claims reports for Pended claims and other Claims reports for the department
Conduct analysis and trending of claims data
Review and price pended claims as a result of high dollar limits and system errors
Develop and distribute Process Bulletins on handling of claims for department as well as the claims department
Compare/verify of provider billings vs. level of care authorized by medical management to assure provider is reimbursed correctly per the contract
Receive and respond to inquiries related to the pricing of pended claims and act as liaison between the Health plan and the Corporate claims department regarding these types of claims
Assist with financial projects involving claims
Complete and respond to internal audit error reports
Track and Trend Pended claims to identify opportunities for eliminating manual processes
Education/Experience: High school diploma or equivalent.
Associate's degree preferred. 5 years claims, health systems, finance or accounting experience in a healthcare environment. Knowledge of State payment regulations and guidelines.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
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