Workers Compensation Claims Technician

• Strong verbal and written communication skills
• Ability to handle multiple tasks simultaneously
• Service and people-oriented
• Dependable and reliable
• Decisiveness

• Communicates with customers and associates over the telephone in person and in written correspondence.
• Answers incoming calls and provides instructions on claim filing requirements determines purpose of calls ensuring professional telephone etiquette.
• Receives examines verifies evaluates and prepares insurance claims requests and forms.
• Reviews and follows up on claims as needed.
• Processes new claims and disseminates the claims to appropriate adjuster.
• Sends denial notification when claim is not covered.
• Performs a wide variety of typing assignments that may be confidential in nature; operates personal computer to enter data draft edit revise and print letters tables reports and other materials.
• Stays abreast of new technologies and principles by conducting research attending seminars educational workshops classes and conferences: reviewing professional publications; establishing networks; participating in professional societies; conferring with representatives of contracting agencies and related organizations.
• Establishes maintains and updates files databases records and/or other documents; develops and maintains data and performs routine analyses and calculations in the processing of data for recurring internal reports.
• Maintains confidentiality of all information.
• Participates in cross-functional team process improvement projects.
• Performs other duties as assigned.

• High School Diploma or GED required.
• Associate degree in Insurance Economics Business Administration or related field preferred.
• One year customer service experience required.
• Experience in insurance claims processing or risk management preferred.
• Minimum typing speed of 40 WPM.
• Must possess a valid drivers license.
• Must be able to successfully pass a background investigation. No felony theft or fraud convictions.

• New employees must complete the Associate in Insurance (AINS) designation within six months from the end of the 90-day evaluation period to be eligible for advancement and incentive compensation.
• For continued employment employees must complete an elective course and six hours of professional development within 12 months after the end of the 90-day evaluation period.

• Ability to become knowledgeable of applicable federal state Tribal and local laws regulations and requirements.
• Ability to become knowledgeable of workers compensation insurance laws policies and regulations.
• Ability to become knowledgeable of medical and insurance terminology and of claims processing practices.
• Ability to become knowledgeable of occupational safety theory principles and practices.
• Knowledge of modern office practices procedures and equipment.
• Ability to communicate effectively in the English language both verbally and in writing.
• Ability to analyze situations and adopt appropriate courses of action.
• Ability to work effectively under stressful conditions.
• Ability to act with integrity and maintain confidentiality.
• Ability to interact and maintain good working relationships with individuals of varying social and cultural backgrounds employees and officials.
• Ability to interpret policies procedures and regulations.
• Ability to monitor expenses and effectiveness of inside/outside vendors.
• Ability to maintain an accurate and organized filing system of complex insurance records and reports.
• Ability to handle multiple tasks and meet deadlines.
• Creative in resolving problems.
• Ability to exercise independent judgment.
• Demonstrated evidence of self-motivation.
• Ability to follow oral and written instruction.
• Ability to collect and analyze data and prepare and present accurate reports and recommendations.
• Skill in performing statistical and mathematical computations.
• Skill in preparing presenting reviewing and analyzing insurance claims forms and reports.
• Skill in providing excellent customer service.
• Skill in using tact and discretion in all communications and providing a positive contribution to the morale of the department.
• Ability to establish and maintain effective working relationships with clients providers and other departments of AMERIND.
• Skill in operating business computers and office machines including in a Windows environment specifically Word Excel Access and presentation software (such as PowerPoint).
• Database management skills.
• Excellent telephone communication skills.

• Typical business office setting with moderate noise level.
• Must be able to sit for work at a computer and phone for more than 6 hours per day.
• Must be able to speak clearly.
• Must be able to use hands for dexterity of motion.
• Frequently required to stand walk and reach with hands and arms.
• Must have ability to occasionally lift 20 lbs.
• Minimal business travel required.

Required Experience:

IC