Reports to: Team Lead
PRIMARY PURPOSE: To provide assistance to the claim staff by performing a variety of administrative tasks based on jurisdictional requirements. Responds to customer inquiries.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Prepares file for legal defense referrals or subpoena responses.
• Prepares variety of letters, reports and forms
• Schedules physician appointments and sends appropriate letters and records
• Edits and organizes a variety of records for Utilization or Legal Review
• Answers phone related inquiries
• Makes outbound calls to request information and follow up
• Prepares various letters, reports and forms.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
• Performs other duties as assigned.
• Supports the organization’s quality program(s).
Education & Licensing
High school diploma or GED required. Relevant work experience can be substituted for required education.
One year of clerical or customer service experience or equivalent combination of education and experience required.
Skills & Knowledge
• Excellent oral and written communication
• PC literate, including Microsoft Office products
• Strong organizational skills
• Efficient time management skills
• Ability to work in a team environment
• Ability to meet or exceed Performance Competencies
• Can determine what next steps are required and proactively respond • Be able to multi task in various systems and/or programs
B. Technical Capacity.
C. Problem Solving.
D. Customer Service Oriented
This job operates in a professional office environment. Calls may be recorded for quality assurance
purposes. This role routinely uses standard office equipment such as computers, phones, photocopiers,
filing cabinets and fax machines.
The physical demands described here are representative of those that must be met by an employee to
successfully perform the essential functions of this job.
While performing the duties of this job, the employee is regularly required to talk or hear. The employee
frequently is required to stand; walk; use hands to finger, handle or feel; and reach with hands and
Position Type/Expected Hours of Work
This is a full-time position. Standard days and hours of work are Monday through Friday, 8:30 a.m. to 5
p.m. Based on business needs this may change. This position can be remote.
Please note this Claims Service Coordinator-Claims Assistant job description is not designed to cover or
contain a comprehensive listing of activities, duties or responsibilities that are required of the employee
for this job. Duties, responsibilities, and activities may change at any time with or without notice.
Equal Opportunity Employer, M/F/D/V