Description
Sets adequate reserves to ensure proper reporting. Compares data on claim form with insurance plan to ascertain completeness and validity of claim. Examines claim form and other records to determine insurance coverage. Proactively works to resolve claim as expeditiously as possible. Reviews and analyze detailed medical records. Calculates reimbursement of benefits according to the schedule of coverage. Runs various claim reports as directed by the account. Approves claims at the appropriately demonstrated assigned authority level. Handles difficult phone calls. Composes special correspondence. Works on special projects and tasks as assigned.
SKILLS:
REQUIRED SKILLS AND EXPERIENCE:
Claims adjudication experience or relevant experience; Experience processing no fault or bodily injury claims. Writes clearly, concisely and effectively. Communicates verbally effectively and with impact. Computer literate. Detail oriented. Ability to multi-task. Manages time effectively. Committed to superior customer servicing. Ability to work independently, a self- starter.