Location: 500 Schoolhouse Road, Johnstown PA 15904 Max Rate: ***
Summary Processes less complex or small standard claims to ensure accurate and timely completion.
Essential Job Functions -Enters insurance claims received electronically or in written form. -Answers incoming customer calls regarding claim processing. Documents claim and associated history. -Evaluates available information to validate straightforward basic claims. Verifies policyholder information, policy effective dates, premium status and verification of claim eligibility.
-Sends claim form to claimant for updating, correction or completion. -Identifies need for additional information; contacts appropriate source to obtain needed information. Verifies beneficiary or claimant information if claim is warranted. Identifies payment amount and obtains required management approvals for payment. -Processes payment.
-Advises claimant of status and resolution of claim. Escalates claimant concerns as appropriate.
Basic Qualifications -High school diploma or G.E.D. -Zero or more years of claims experience -Experience working with insurance and/or medical terminology -Experience working with appropriate claims processing procedures and documentation
Other Qualifications -Basic analytical and problem solving skills -Interpersonal skills to interact with team members -Communication skills to communicate with customers