Under general supervision responsible for timely and accurate processing of non-technical claim duties utilizing procedures and processes to perform routine activities. Analyzes and troubleshoots to resolve complex activities.
Essential Duties Responsibilities
- Completes regulatory forms timely in accordance with regulations by evaluating claim information. Provides information to claim adjusting staff from regulatory websites.
- Completes data or makes data corrections based on set requirements or procedures within claim file information utilizing multiple claim systems that support PC Claim.
- Performs various financial transactions such as paying bills payment transfer cashier processing etc. utilizing set procedures and guidelines.
- Collaborates with underwriting insureds claimants providers vendors or claim adjusters utilizing various methods to obtain and provide information related to claim support activities.
- Completes form letters or documents based on procedures or set requirements.
- May receive new claim notices confirm coverage and/or verify applicability of coverage to the claim.
- Serves as Day to Day resource for procedural or process questions.
- Accountable for reviewing and reconciling reports for data or financial transactions related to claims.
- May perform routine processing within designated authority on medical only claims following jurisdictional parameters.
- May complete special projects as necessary.
Typically Supervisor or above
Skills Knowledge and Abilities
1. Ability to navigate multiple system applications.
2. Knowledge of PC insurance products and services.
3. Ability to produce high quality outcomes in a highly productive environment. 4. Ability to evaluate information within a claim file to execute upon various tasks.
5. Strong data entry skills and attention to detail.
6. Good verbal and written communication skills.
7. Good organizational and follow-up skills.
8. Good listening and customer service skills.
9. Ability to work independently.
10. Ability to make sound judgments based on available information.
11. Knowledge of Microsoft Office Suite and other business related software.
Education and Experience
1. High school diploma GED or equivalent experience. Some college preferred. 2. Typically a minimum of one to three years experience in office operations and one to two years experience in Property and Casualty line of business preferred.