Demonstrates beginner to intermediate knowledge of the claims operations and the ability to address simple requests and complaints received via telephone, email, or voicemail, with some guidance.
Performs daily mail pickup, scanning and file functions; sorts and distributes mail & maintains/purges documents according to record retention guidelines.
Utilizes the multiple systems to identify the appropriate recipient of correspondence; distributes electronic records accordingly.
Expands upon and employs problem-solving skills and learns the investigative methods needed to actively seek information required to resolve inquiries and issues.
May learn to execute basic claim setup and entry, coverage verification, and financial transactions.
Learns to identify discrepancies in information gathered.
Becomes familiar with and utilizes multiple computer systems for policy analysis, claim management, data management, reporting, and productivity.
Learns to utilize ClaimExpert, ClaimConnect, ClaimCenter, OpsNow, and Outlook to track workload, manage activities, remain organized, and timely.
Refers non-routine/complex issues to manager or more experienced staff.
May assist with and/or create general correspondence.
Maintains a professional demeanor in all situations.
Performs all other duties and tasks as assigned. Works productively under close supervision; relies on instructions and pre-established guidelines to perform the functions of the job

High school diploma is required
Related billing claims assistant, claims processing or claims operations support experience is required
Workers' compensation claims experience is preferred
Excellent communication skills in both written and verbal form is required
Must be able to work with accuracy and speed with a variety of internal and external contacts
Reliable transportation is required

Claims Operations Associate – Workers Compensation

Key skills