Claims support specialist job description

Inclusa is seeking a Authorization & Claims Support Specialist who is a self-starter with strong organizational skills, judgement and independent decision making abilities. We desire a colleague that is able to maintain professional and service-oriented relationships that align with our vision, 'The innovative leader in building vibrant and inclusive communities, Inclusa empowers full and meaningful lives of those we serve. Application Deadline: Monday, October 17th.

Under the supervision of the ACA SupportTeamManager,the AC SupportSpecialistisresponsible for the day-to-dayauthorization and claimsprocessing andsupport.TheAC SupportSpecialistwill partner withother stakeholderstoensure excellent customer service is provided to members/providers, and services/supports are authorized and paid for in an accurate and timely manner.

Authorization & Claims Support Specialist (AC Support Specialist) duties include:

Processand support authorization entry for member services/supports in accordance with guidelines, policy and procedures.

• Engage in training onauthorizationrelatedguidelines, policy, and procedures and become proficient in their content.
• Engage in training on applicable systems and technology to enhance productivity.
• Enter the correct amount, frequency, and coding for the appropriate services from the referral or other source documentation in a timely manner.
• Routinely meet established authorization entry benchmarks and goals.
• Research referral errors and/or omissions and seek resolution in a timely manner.

Provide claims supportfor member services/supports in accordance with guidelines, policy and procedures.

• Engage in training onclaimsrelated guidelines, policy, and procedures and become proficient in their content.
• Engage in training on applicable systems and technology to enhance productivity.
• Collaborate with WPS and other stakeholders to support timely provider claim payment andtoreduce the frequency of claim rejections or denials.
• Researchclaimerrors and/or omissions and seek resolution in a timely manner.
• Research and support authorization and claim audit and appeal activities.

Who is Inclusa?


Inclusa through its founding organizations, pioneered Family Care in Wisconsin and has been serving the people of Wisconsin since 2000. We are presently in 68 counties servicing nearly 16,000 members, the frail elderly and adults with disabilities, in a strengths-based manner that supports goals and what is important for each individual.We promote a culture of coaching to success. Your professional development is viewed as paramount to our growth and reputation. We strive to see you succeed and grow, both personally and professionally. In addition to working in a team focused and collaborative work environment, you would be offered robust benefits options.


**Candidates are able to work remotely anywhere in the state of WI.



Deadline Date: We will be accepting applications for this position Monday, October 17th.


Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)

Hybrid Claim Support Specialist - (220001YY) Description Claim Support Specialist - The Auto Club Group
What you will do:
The Auto Club Group is seeking prospective Claim Support Specialist who will work in accordance with established guidelines, assign claims, electronically and recognize subrogation potential and refer claims to appropriate area as indicated.
In this position, you will have the opportunity to:

Update claims files to document assignments.
Review claims assignments within assigned area to ensure proper load-balancing.
Perform quality control tasks to ensure the timely assignment of claims.
Notify management of system problems or potential issues.
Forward claim files to appropriate areas (e.g. Legal) as necessary.
Clerical printing work

Perform a variety of high-level support duties to ensure the proper handling of claims.
Assist management in the support of department projects and research and compile requested information.
Gather information for management reports.
May enter, process, retrieve and/or correct data to ensure systems are updated and management has correct information to respond to inquiries.
Processing payments for invoices.

Assist other staff members in performing claim support functions such as typing correspondence/memos and responding to telephone inquiries as needed during peak periods/staff shortages.
Answer customer/vendor calls and provide information, as needed.
Perform other related duties as assigned.

With our powerful brand and the mentoring we offer, you will find your position as a Claim Support Specialist can lead to a rewarding career at our growing organization.
How you will benefit:
Claim Support Assistant will earn a competitive salary of $36,000 to $48,000 annually with annual bonus potential based on performance.

Excellent and comprehensive benefits packages are just another reason to work for the Auto Club Group. Benefits include:

401k Match
Medical
Dental
Vision
PTO
Paid Holidays
Tuition Reimbursement

Qualifications We're looking for candidates who:
Education:

High school education or equivalent

Experience:

Experience with P.C. software applications
Preparing claim files and diary entries
Letter writing

Knowledge of:

General claim processing functions
Claim processing system
Insurance processing, including the understanding of policy/coverage terminology

Ability to:

Work under pressure
Organize and prioritize work
Prepare claim files
Communicate effectively with others over the telephone and in person
Sit for the majority of the day
Handle multiple tasks
Use automated processing and computer systems
Rotate within department to perform various training or support functions
Provide high quality customer service
Analyze and problem solve

What it's like to work for us:
We serve our members by making their satisfaction our highest priority. We do what's right by sustaining an open, honest and ethical work environment. We lead in everything we do by offering best-in-class products, benefits and services. And we value our employees by seeking the best talent, rewarding high performance and holding ourselves accountable.
All in all, we create an inclusive and welcoming environment of diverse backgrounds, experiences and viewpoints, realizing our differences make us stronger.
Who we are:
The Auto Club Group helps AAA Members enjoy life's journey with peace of mind by providing innovative solutions, advocacy and membership benefits wherever and whenever they need them. We currently conduct business in 13 states in the upper Midwest and the Southeast.
The Auto Club Group has established four long-term enterprise goals:

Long-term, sustainable, profitable growth
AAA Membership growth and renewal
Operational excellence
Become the “flagship club” of the AAA Federation

Important Note:
ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals. ACG utilizes a geographic pay differential as part of the base salary compensation program. Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates. Salary at time of offer is determined based on these and other factors as associated with the job and job level.
The above statements describe the principle and essential functions, but not all functions that may be inherent in the job. This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfil these requirements.
The Auto Club Group, and all of its affiliated companies, is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status.

#LI-AH2

Primary Location: United States-FL-TampaWork Locations: FL-ACG Florida AOB 9125 Henderson Road Tampa 33634Job: ClaimsOrganization: ClaimsSchedule: Full-time Shift: DayEmployee Status: RegularJob Type: RegularJob Level: Individual ContributorTravel: NoJob Posting: Aug 30, 2022, 1:11:38 PM

Division or Field Office:

Allentown/Bethlehem Branch Office
Department of Position: Claims Department
Work from:
Branch Office

At Erie Insurance, you're not just part of a Fortune 500 company; you're also a valued member of a diverse and inclusive team that includes more than 5,000 employees and over 2,200 independent agencies. Our Employees work in the Home Office complex located in Erie, PA, and in our Field Offices that span 12 states and the District of Columbia. To attract and retain the best talent, we reward our team members with competitive salaries and a very generous benefits package.

Position Summary

Under moderate supervision, performs basic claims/zone support activities.

• The successful candidate will work Monday-Friday, 8:00a.m.-4:30p.m.
  
• A hybrid work schedule will be available
  
• The hiring manager will also consider candidates for Claims Support Specialist II.Level of position offered will be based upon the depth and breadth of selected candidate's experience and qualifications.
  

Duties and Responsibilities

Performs support and administrative functions, including answering phones, filing, copying/imaging, faxing, processing and distributing mail and supporting third party vendor relationships and processes. Orders supplies and schedules/coordinates meetings. Greets and directs visitors to appropriate personnel.

Provides inbound and outbound phone support and customer service to all customers including policyholders, claimants, and agents, and handles all inquiries with customer service as a priority.

Provides customer service support during weather events including CAT loss reports and other CAT support duties. Provides support in various disciplines including material damage, property, liability, subrogation, workers compensation, medical, and litigation. Assists with various activities including preparing and processing documents, preparing time sensitive and confidential claim file information on a routine basis. Assist with follow up calls and other claim file support as needed.

Greets, screens and directs visitors to appropriate personnel.

Applies a working knowledge of policies and procedures, verifies and provides claims information, and offers initial services. Assists personnel with various activities including accessing and verifying policyholder information. Sets follow ups as appropriate for completion of support activities.

Duties and Responsibilities (cont'd if applicable)

Responds to inquiries from customers, including but not limited to, adjusters, Policyholders, Agents, independent adjusters and claimants and/or refers to others as required. Handles all inquiries with customer service as a priority.Enters new loss report information and updates claims documentation.

Handles claims related financial transactions including transfers, recoveries, and recodes for claims files as needed.

Assists with special projects as required.

The first six duties listed are the functions identified as essential to the job. Essential functions are those job duties that must be performed in order for the job to be accomplished.

This position description in no way states or implies that these are the only duties to be performed by the incumbent. Employees are required to follow any other job-related instruction and to perform any other duties as requested by their supervisor, or as become evident.

Competencies

Self-Development

Collaborates

Cultivates Innovation

Instills Trust

Decision Quality

Values Diversity

Nimble Learning

Customer Focus

Optimizes Work Processes

Ensures Accountability

Detail Orientation

Information Management Skills

Job-Specific Knowledge

Qualifications

High school diploma or GED required. Demonstrated ability to type a minimum of 35 words per minute and 80 net data entry keystrokes per minute preferred. Completion of LOMASelect tests required. Passing score on LOMASelect tests required. Office or general claims support experience preferred. Valid driver's license preferred. Working knowledge of word processing and spreadsheet software required.

Physical Requirements

Lifting 0-20 lbs; Frequent (50-80%)

Lifting 20-50 lbs; Occasional (
Lifting Over 50 lbs; Occasional (
Driving; Occasional (
Pushing/Pulling; Frequent (50-80%)

Manual Keying/Data Entry; Frequent (50-80%)

Climbing; Rarely


Nearest Major Market:
Allentown