Claims Processor I (Insurance)

AF Group’s focused and passionate team uses industry-leading best practices, analytics and resources to manage risk and minimize loss for our policyholders while strengthening businesses with our valued independent agent partners.

We strive to continuously increase the long-term value of our organization by outperforming our industry peers and fostering a culture of underwriting and claims excellence.

Analysis and entry of detailed payment data into the claim system for all states including manual states, contact ...

Analyzes, validates, approves and processes attorney, legal, IME, vocational rehabilitation, medical management and all other vendor invoices.High School Diploma or G.Advanced training or college level coursework in ...

Two years general office experience performing relevant duties that provides the necessary skills, knowledge and abilities. Additional training, work experience, or course ...

Basic knowledge of computers and spreadsheet software with data entry ability. Basic knowledge of Word Processing software.

AF Group’s focused and passionate team uses industry-leading best practices, analytics and resources to manage risk and minimize loss for our policyholders while strengthening businesses with our valued independent agent partners.

We strive to continuously increase the long-term value of our organization by outperforming our industry peers and fostering a culture of underwriting and claims excellence.

and its subsidiaries are a premier provider of innovative insurance solutions. Insurance policies may be issued by any of the following companies within AF Group: Accident Fund Insurance Company of America, Accident Fund National Insurance Company, Accident Fund General Insurance Company, United Wisconsin Insurance Company, Third Coast Insurance Company, or CompWest Insurance Company.

Claims Processing

Analysis and entry of detailed payment data into the claim system for all states including manual states, contact with employers to obtain missing payment information or to clarify information submitted, issuance of non-indemnity and non-medical payments and manual payments, processing of refunds and transfers, handling route back checks for distribution, posting manual payments, research and resolution of returned non-medical checks. Contacts include agents, policyholders, claimants, attorneys, and other Claims Department and Service Center staff.

Verifies, calculates, and pays approved injured worker travel and miscellaneous expenses.

Validates, investigates and completes refund and transfer documents.

Analyzes, validates, approves and processes attorney, legal, IME, vocational rehabilitation, medical management and all other vendor invoices.

Contacts agents, policyholders, and injured workers to verify or gather claim information.

Alerts Claim Handlers on reserve deficiencies.

Participates on projects as requested.

Post Excess & TPA Payments to claim files.

Post internal claim costs.

Provides assistance as a Subject Matter Expert for procedures and workflow documentation.

Verifies, calculates, and pays approved injured worker travel and miscellaneous expenses.

Validates, investigates and completes refund and transfer documents.

Analyzes, validates, approves and processes attorney, legal, IME, vocational rehabilitation, medical management and all other vendor invoices.

Contacts agents, policyholders, and injured workers to verify or gather claim information.

Alerts Claim Handlers on reserve deficiencies.

Participates on projects as requested.

Post Excess & TPA Payments to claim files.

Post internal claim costs.

Provides assistance as a Subject Matter Expert for procedures and workflow documentation.

High School Diploma or G.Advanced training or college level coursework in business, accounting, or insurance. Combination of education and experience may be considered in lieu of additional training or coursework.

Two years general office experience performing relevant duties that provides the necessary skills, knowledge and abilities.

High School Diploma or G.Advanced training or college level coursework in business, accounting, or insurance. Combination of education and experience may be considered in lieu of additional training or coursework.

Two years general office experience performing relevant duties that provides the necessary skills, knowledge and abilities.

Basic knowledge of computers and spreadsheet software with data entry ability.

Basic knowledge of Word Processing software.

Ability to enter alpha-numeric data accurately.

Ability to verify data for accuracy.

Additional training, work experience, or course work in workers compensation, insurance or accounting.

Experience using a document management system with workflows.

High School Diploma or G.Advanced training or college level coursework in business, accounting, or insurance. Combination of education and experience may be considered in lieu of additional training or coursework.

Two years general office experience performing relevant duties that provides the necessary skills, knowledge and abilities.

High School Diploma or G.Advanced training or college level coursework in business, accounting, or insurance. Combination of education and experience may be considered in lieu of additional training or coursework.

Two years general office experience performing relevant duties that provides the necessary skills, knowledge and abilities.

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