Claims Administrative Rep

Looking for a dedicated career admin service person.  Only serious inquiries need apply. Competitive pay with comprehensive benefits package.

This position supports the Claims Division in achieving and promoting the lowest fair claims settlement. This position is responsible for the routine administrative and customer service aspects of the claims handling process according to the established guidelines of the Claims Division.

I. AUTHORITY – Only applicable for the department listed below

Entering Drafts, payments and setting up reserves

Workers’ Compensation & Managed Care: $5,000

II. COMPETENCIES AND Essential Duties

Team Building

· Adheres to the work group’s expectations and guidelines; fulfills team or work group responsibilities; demonstrates personal commitment to group goals.

· As directed by leadership, this position will be responsible for training team members on current processes.

Attention to Details

· Enters data into the claims processing systems as instructed by the Team Leaders, Claims Managers, or adjusters while adhering to quality and productivity guidelines established by the claims division.

· Claims Division: Inputs the proper coverage(s) and classification(s) when setting up new claims.

· Claims Division: Answers Claims switchboard calls (approximately 300 calls per day), providing callers with basic information and transferring calls to proper adjusters.

· Inputs claims to the correct line of business.

Quality Orientation

· Performs duties outside of the claims systems, such as filing, distribution of mail, check printing and other various tasks, in support of the claims division.

· Claims Division: During periods of high claim volume, provides prompt and professional customer service to agents, policyholders, and internal customers regarding new claim notification, inquiries, and requests received via telephone, fax, email, or internet.

· Ability to validate adjusters’ clerical requests.

Planning &Organizing

· Research policy/or policy or client procedures and other systems to resolve claims processing issues.

Positive Approach

· Communicates with internal and external customers by phone, fax, and e-mail in a professional and courteous manner.

Applied Learning

· Puts new knowledge, understanding, or skill to practical use on the job; furthers learning through practice and ongoing feedback.

· Readily absorbs and comprehends new information and develops skills from formal and informal learning experiences.

Performs various projects requested or assigned by the employee’s reporting manager noted above.

III. CORPORATE CORE COMPETENCIES

Effectively Communicates and Connects

· Communicates clearly and concisely.

· Prepares written communications that adhere to department standards.

· Attentively listens and asks clarifying questions.

· Builds a positive relationship within the workplace.

Customer Focused

• Develops and maintains knowledge about the needs of customers and how the team provides value.
• Aware of customer risks and when to escalate risks.
• Identify and utilize the appropriate resources to solve customer problems.
• Accelerates follow-up and action to resolve issues.

Talent Development Mindset

• Brainstorm ideas for technical and/or professional development.
• Work with supervisor to identify relevant development opportunities, shadow opportunities, including technical skill building and professional skill enhancement.
• Act on opportunities to recognize colleagues for a job well done.

Proficiency Description

Demonstrates Adaptability

• Seeks to understand others' needs and perspectives, especially those different from my own.
• Open to learning about new and challenging ideas to drive the success of the work in which I am involved.
• Learning how to be flexible to accommodate deliverables and prioritize work effectively.

Demonstrates Accountability

• Takes ownership of mistakes and consults with others to resolve, learning from the experience.
• Consistently checks the accuracy of work.
• Provides coverage or assistance to others when needed.
• Proactively steps-up to provide guidance or assistance.

IV. SPECIAL RELATIONSHIPS

• Direct contact with the Claims Service Office Managers, Team Leaders, and adjusters
• Direct contact with various levels of Home Office Claims personnel
• Claims Division: Direct contact with various levels of Underwriting personnel

VI. QUALIFICATIONS

Education/Credentials

• High School diploma, or equivalent

Experience

• Prior customer service experience preferred

Technical/ Professional Knowledge

• Good interpersonal skills, with the ability to interact in a professional and tactful manner
• Good communication skills – both verbal and written
• Good Personal Computer skills, with an emphasis on Microsoft Office Suite
• Strong keyboard, data entry and typing skills required, along with the ability to perform various clerical duties
• Ability to perform standard business mathematics
• Must be able to multi-task and perform job responsibilities with the interruption of phone calls
• Must be able to work as a team member in a fast-paced environment
• Must be adaptable and able to quickly adapt to schedule changes

V. JOB REQUIREMENTS (as required by ADA – Americans with Disabilities Act)

• This position is primarily a sedentary position that requires occasional standing and walking throughout the office environment.
• Must be able to see and effectively use a computer monitor.
• Must be able to operate a computer, keyboard and applicable printers and other general office equipment.
• Must be able to access and enter information accurately using automated systems.
• Must be able to hear and communicate via the telephone and/or monitoring devices to both internal and external clients.
• Must be able to present information to individuals and groups.
• Must be able to interpret and apply concepts that may or may not be based upon established guidelines.
• Must be able to maintain acceptable attendance and adhere to scheduled work hours.
• Must have a valid driver’s license and be able to operate a motor vehicle.
• Must be able to travel, with overnight stays required.

Salary range: $40,000 - $45,000 per year

Posted On: Wednesday, January 11, 2023