DEPARTMENT: CLAIMS
REPORTS TO: Claim Supervisor
STATUS: Non-Exempt
HOURS: Mon - Fri / 8am - 5pm
REQUIREMENTS:
- College degree in Accountancy, required.
- Computer literacy; familiarity with Microsoft Office a plus.
- This individual will adhere to the code of ethical conduct and is required to engage in fair claims settlement practice in accordance with the workers’ compensation law.
- Must be able to type 45 WPM.
- 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.
- 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 the following skills:
- Good listening; and good written and communication skills.
- Ability to multi-task and stronghold the understanding of human nature and motivation principles.
- Readily control/handle problem issues in times of stress, and/or in a climate of conflict or adversity.
- Ability to document claim file activities is required.
- Responsiveness to changing business or customer needs.
If interested, please send resume and cover letter with salary requirements to:
