JOB SUMMARY

Assists with the direct processing of claims, billings or payments related to County liability, subrogation or workers compensation. Facilitates the movement of claims through the process, gathers and verifies information required to process a claim, payment or subrogation.   

MINIMUM QUALIFICATIONS

Two (2) years of related experience; OR an equivalent combination of related education and experience.

Preference will be given to candidates with experience administering workers’ compensation, automobile, property, liability claims and/or medical billing.

Due to the nature of this position, the successful applicant must successfully pass an initial criminal background check as well as every two years thereafter and continuously meet the requirements of the Bureau of Criminal Identification (BCI).

ESSENTIAL FUNCTIONS

• Assists attorneys, risk manager and adjustors with processing claims, subrogation and workers compensation paperwork.
• Reviews files for missing documentation, contacts third parties to request claim documentation, prepares incoming information and enters the information into a claims information system.
• Prepares files, reports and related materials for review to document claims, subrogation and workers compensation.
• Obtains insurance information, medical documentation, payment and billing records or records supporting claim. Coordinates with adjustors, attorneys or risk manager in finalizing documentation for claims, subrogation or workers compensation.
• Reviews and prepare files, archives files and gathers supporting documentation from claimants, witnesses, law enforcement, medical professionals or insurance companies.
• Compiles information and enters data into a claims management system. Updates the claim management system with incoming data, updated losses, medical, billings or payments made.
• Prepares and drafts correspondence, claimant notices, requests for information, settlements, releases, and discharges of title.
• Prepares and files electronic workers compensation forms, first report of injury (FROI) and supplemental claim documentation.
• Interacts with attorneys and opposing counsel, law enforcement, claims adjustors, risk manager, safety manager, claimants, insurance agencies, other agencies and the public.
• Performs computer searches, data inquiries, and creates reports to coordinate billings and payments.
• Prepares and maintains insurance files and claimant files.
• Searches public and private records.

KNOWLEDGE, SKILLS AND ABILITIES (KSA)

Knowledge of:

• Liability insurance, workers compensation reporting and claims process, medical billing and adjusting process, subrogation process
• General secretarial/clerical and office procedures and techniques
• Legal terminology
• Medical terminology including ICD-9 codes
• Office technology systems
• Business English, proofreading and editing techniques
• Insurance claims practices
• Civil and workers compensation court procedures
• Process for payments and billing documentation
• Filing systems and procedures for workers compensation and County web portals
• Document control

Skills and Abilities to:

• Type accurately at 40+ words-per-minute
• Perform claims processing tasks using independent judgment
• Work with computer software related to job specific duties
• E-file with administrative agencies
• Initiative and ability to work independently with minimal supervision
• Organize workloads and prioritize tasks to adhere to deadlines
• Work and communicate with public, outside agencies, attorneys and risk management staff
• Respond to inquiries in a prompt, courteous and professional manner
• Communicate effectively both verbally and in writing