SECURA Insurance

Claims Customer Service Representative

US-WI-Appleton
2 weeks ago(11/30/2017 1:02 PM)
Job ID
2109
Job Grade
Grade 5
Category
Claims - Workers’ Compensation

Responsibilities

  • Set up claim files and verify coverage
  • Process claim checks
  • Answer general claims questions or forward calls to the appropriate contact
  • Process incoming and outgoing mail
  • Maintain the paperless filing system
  • Provide superior customer service for all internal and external customers
  • Review and analyze payment of medical charges
  • Manage bill review process
  • Handle escheats and bulk billing payments
  • Prepare Excel spreadsheets and data analysis
  • Process and ensure compliance with Medicare SCHIP reporting
  • File appropriate State EDI forms and updates
  • Provide backup assistance as necessary

 

Qualifications

ESSENTIAL:

  • High school diploma or GED
  • Great keyboard/PC skills
  • Superior verbal communication skills
  • Excellent problem-solving skills
  • Great organization and prioritization skills
  • High proficiency in Excel (including complex formulas, data analysis, etc.)
  • Must have an A+ team attitude
  • Ability to work flexible shift

 

PREFERRED:

  • Medical claims experience and/or medical records terminology knowledge
  • Associate’s or college degree
  • Introductory insurance coursework
  • Previous customer service experience
  • Basic understanding of property and casualty insurance
  • Proficient in Spanish, written and verbal

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