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Administrative Claims Specialist

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Plymouth Rock Assurance

2mo ago

  • Job
    Full-time
    Entry, Junior, Mid & Senior Level
  • Customer Relations
    People, HR & Administration
  • Woodbridge

AI generated summary

  • You need a high school diploma/GED, relevant training or experience, PC skills, ability to follow instructions, prioritize tasks, and produce quality work in a fast-paced environment.
  • You will enter data, research legal mail, process claims checks, assist medical providers, handle projects in Excel, review medical bills for accuracy, and support team objectives.

Requirements

  • High school diploma or general education degree (GED) and related training (i.e. medical billing, medical terminology, data entry); or six months related experience; or equivalent combination of education and experience.
  • Ability to understand and carry out instructions furnished in written, oral, or diagram form.
  • Ability to deal with problems involving several concrete variables in standardized situations.
  • Basic personal computer skills including electronic mail, word processing, spreadsheet, graphics, etc.
  • Ability to handle multiple tasks simultaneously.
  • Ability to work independently and prioritize projects and activities to meet deadlines.
  • Consistently produces a quality work product with attention to detail.
  • Comply with all safety policies, practices and procedures.
  • Ability to work in a fast paced environment.

Responsibilities

  • Manual data entry of lawsuit information and medical claim bills in a paperless environment using dual monitors.
  • Research and indexing of legal related mail for claim updating and assignment
  • Keying of Claims checks including expenses, arbitration settlements, interest, etc.
  • Provider Service Unit Operator; utilizing customer service skills to provide information to medical providers regarding billing, and/or treatment requests.
  • Ability to use all available applications to answer questions, within our guidelines, prior to transferring calls.
  • Project Handling; Knowledge of Microsoft Excel, Word and Outlook. Perform research and compile data onto an excel spreadsheet for analysis.
  • Report generation and distribution.
  • Review of Medical Bills; Review accuracy in billing, pre-certification compliance in accordance with the Decision Point Review Plan, and application of proper bill adjudication.
  • Participate in proactive team efforts to achieve departmental and company goals.
  • Perform other duties as assigned to support the various units within the claims department.

FAQs

What are the main responsibilities of an Administrative Claims Specialist?

The main responsibilities include manual data entry of lawsuit information and medical claim bills, researching and indexing legal-related mail, keying claims checks, providing customer service to medical providers, performing data analysis in Microsoft Excel, reviewing medical bills for accuracy, and participating in team efforts to support departmental goals.

What qualifications are required for this position?

A high school diploma or GED is required, along with related training in medical billing or data entry, or six months of relevant experience. Basic computer skills and the ability to handle multiple tasks are also necessary.

Is experience in medical billing necessary for this role?

While specific experience in medical billing is preferable, it is not strictly necessary. Related training or a combination of education and experience is accepted.

What software applications should I be familiar with for this position?

Familiarity with Microsoft Excel, Word, and Outlook is required for research, report generation, and data management tasks.

How does the company support employee growth and development?

The Plymouth Rock Company invests in technology and provides an empowering environment that allows employees to thrive, contributing to their professional growth.

What kind of work environment can I expect?

You can expect a fast-paced work environment that requires the ability to prioritize tasks and work independently while consistently delivering quality work.

Will there be opportunities for training in this role?

Yes, there may be opportunities for training in medical terminology, data entry, and other relevant areas to ensure you are equipped to perform your duties effectively.

Is this position full-time or part-time?

The job listing does not specify, but it typically falls within full-time employment for positions in administrative claims handling.

How is performance evaluated in this position?

Performance is likely evaluated based on the accuracy and quality of the work produced, attention to detail, ability to meet deadlines, and participation in team efforts.

Are there any safety policies I need to comply with?

Yes, all employees are expected to comply with safety policies, practices, and procedures as part of their role.

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Plymouth Rock Assurance

Plymouth Rock. Get more from your Auto and Home Insurance.

Finance
Industry
1001-5000
Employees
1983
Founded Year

Mission & Purpose

If you’ve found your way to our LinkedIn page, you’re likely here for one of two reasons: You’re reviewing insurance companies or you’re browsing new career opportunities. Well, you’ve come to the right place. Insurance Customer In just 35 years, Plymouth Rock Assurance has grown to be one of the leading auto and home insurers in the Northeast. With unique features like Crashbusters® mobile claims vans, Door to Door Valet Claim Service®, the Get Home Safe® taxi and rideshare benefit, Road Rewards® and our Home Insurance Quick Quote, we’re committed to delivering our customers “More Than Just Insurance.”