Claims Admin

Responsibilities

• Ensures Claims Best Practices guidelines are followed consistently when applicable.
• Ensures that defined processes, quality standards and procedures are followed.
• Maintains file notes in accordance with established procedures.
• Provides timely information to adjusters, leadership, clients, claimants, doctors, and other stakeholders regarding the status of pending tasks.
• Reviews all necessary documentation to find answers prior to reaching out to adjusters for assistance.
• Understands Medicare screens to meet Section 111 requirements and assists with exception reporting to correct errors timely and accurately.
• Communicates effectively with all internal and external business partners. Written and verbal communication is professional and timely.
• Expresses oneself in a clear and concise manner in one‑to‑one and group discussions while listening attentively in collaborative discussions.