Claims Associate

Claims Processor

Under direct supervision, performs basic claim handling functions to include data entry, bill payment, ordering various reports from outside parties, preparing and filing various required forms. Interacts with clients and outside vendors for various reasons including but not limited to gathering data and scheduling appointments.

Processing medical only claims as assigned, within requirements set by client service instructions and SMART Safety Group Practices. Work activity includes but is not limited to, review, approval and payment of medical bills and bills from other service providers as required.

The current position includes the following duties, but not limited to:

• Enhance the image and reputation of SMART Safety Group. By exercising sound, ethical business practices in all relations with customers, employees, suppliers and others and ensure all practices comply with the Company's quality procedures.
• Provide administrative assistance to Claims Manager by:
• Following-up on claims with insurance companies, scheduling doctor appointments and assisting injured employee as needed.
• Send medical records to various point of contacts as necessary.
• Scan and submit documents into SMART Safety Group data base.
• Extensive data entry and assisting with phone calls as needed.
• Translate documents from Spanish to English as necessary.
• Update contact list as necessary and interact with various Safety Managers.
• Maintain organized documents and ensure that they are always up-to-date.
• Be able to read medical reports and update involved parties immediately.
• Able to maintain up to 60+ cases at a time.
• Assist with phone calls.
• Assist in meetings
• Other duties as assigned

Requirements:

• 3 years of claims experience in worker's compensation.
• Min. of a High School Diploma and some college.
• Able to work overtime if necessary
• Bilingual (English/Spanish), both oral and written.
• High attention to detail a MUST.