Insurance Claims Processor

Member Operations - Claims

Primarily responsible for reviewing and compiling all pertinent claim related documentation from various systems including doing claim benefit calculations prior to submission of claim to the insurance carrier.

  • Work in multi-carrier and multi-product environment so required to keep up with numerous policies and procedures
  • Various additional daily duties include the quality control of claims, claims correspondence, shipping original claim documents to the carrier, and producing certificates of insurance all within metric standards set by department
  • Enter claim information in multiple systems for proper maintenance of company records
  • Communicate directly with insureds, claimants, financial institutions, and carriers both verbally and via email

CORE COMPETENCIES AND SKILL SETS:

  • Detailed oriented with ability to multi-task and meet production and quality standards
  • High level of accuracy
  • Good analytical and decision making skills
  • Must have ability to work in team environment, however, also have the ability to make independent decisions
  • Superior customer service and communication skills both verbally and written (proficient typist)
  • Knowledge of Word, Excel, and AS400 (a plus) and other computer applications

EDUCATION AND EXPERIENCE:

  • High School degree required with some College or a College Degree a plus
  • 2+ years’ experience in insurance industry