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Worker's Compensation Claims Administration Analyst

Company: Salus Workers Compensation LLC
Location: Lewisville
Posted on: January 12, 2022

Job Description:

Description:
Summary/Objective
Under the direction of the Director of Claims Operations, the Claims Administration Analyst provides professional administrative support to the claims team and responds to customer questions or requests for general claims information.
Essential Functions


  • New claim set up: entering claim into the claim system of record as needed, initial EDI FROI, and ISO entry
  • Payment issuance: issue claim indemnity and expense checks which could include Electronic Funds Transfer
  • Research outstanding indemnity, expense and medical checks and submit void, stop pay and re-issuance requests
  • Child support entity set up
  • Mail: receive, review, sort, date stamp, index and properly route all mail received in the office. Add postage to all outgoing correspondence. Complete certified mail and overnight mail requests. Scan, upload and distribute documents to claim system
  • Communication: receive and return calls from medical providers seeking status of medical bill payments. Send proof of payments and EOR's upon request. Respond to general claim inquiries such as requests for claim number, adjuster name, billing address, general claim questions, etc.
  • Reporting: ISO search & EDI FROI at the request of an adjuster
  • Notary: perform notary public registration and offer services when necessary
  • Claim Files: Copy claim files upon request. Ensure closed files are appropriately tracked and filed. Maintain organization of closed filings. Scan & upload claim correspondence to the claim file.
  • Assist with the general clerical overflow as needed including coordination of property management need to access the office space, order kitchen and office supplies
  • Perform other duties as assigned

    Competencies

    • Must have professional telephone etiquette
    • Must be customer service oriented
    • Strong organizational skills
    • Excellent oral, written and interpersonal communication skills
    • Detailed oriented with the ability to work in a team environment and be flexible to changing needs and job duties

      Supervisory Responsibility
      This role has no supervisory responsibility
      .Requirements:
      Technical Skills Required
      PC literate, including Microsoft Office and Google Products
      Work Environment & Physical Demands
      This position operates in a professional office setting and is largely a sedentary role. However, some filing is necessary and may require the ability to lift files, open filing cabinets and bend or stand on a stool as necessary.
      Position & Expected Hours
      This is a full-time, salaried exempt position. Typical work hours and days are Monday through Friday, 8:00 am to 5:00 pm. Some flexibility in hours is allowed, however the employee must be available during the "core" work hours of 9:30 am to 3:30 pm and must work 37.5 hours each week.

      Travel
      Minimal to no travel required
      Required Education & Experience

      • High school diploma or GED required, with some college
      • At least two years of related experience
      • Knowledge of general office, administration, or clerical functions
      • Insurance experience is preferred
      • Licenses as required

Keywords: Salus Workers Compensation LLC, Lewisville , Worker's Compensation Claims Administration Analyst, Professions , Lewisville, Texas

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