Claims Payment Specialist

Compensation:
Competitive Compensation and Benefits Package

AF Group’s focused and passionate team uses industry-leading best practices, analytics and resources to manage risk and minimize loss for our policyholders while strengthening businesses with our valued independent agent partners.

We strive to continuously increase the long-term value of our organization by outperforming our industry peers and fostering a culture of underwriting and claims excellence.

Responsible for all of the following duties Enterprise wide;
Analysis and entry of detailed payment data into the claim system for all states including manual states, contact ...

Review

Review payment requests to ensure compliance with the Workers Compensation regulations.

Contact policyholder for payment clarification and to obtain necessary ...

Procedure

Analyzes, validates, approves and processes attorney, legal, IME, vocational rehabilitation, medical management and all other vendor invoices.

Contacts agents ...

Education

Relevant combination of education and experience may be considered in lieu of degree. High School Diploma or G.E.D. Advanced training or college level coursework in ...

Experience

Two years general office experience performing relevant duties that provides the necessary skills, knowledge and abilities. Additional training, work experience, or course ...

Skills

Excellent organizational skills and ability to prioritize work to meet established deadlines.

Math skills with the ability to use a ten-key calculator.

Demonstrated ability to ...

Knowledge

Basic knowledge of computers and spreadsheet software with data entry ability. Basic knowledge of Word Processing software.

AF Group’s focused and passionate team uses industry-leading best practices, analytics and resources to manage risk and minimize loss for our policyholders while strengthening businesses with our valued independent agent partners.

We strive to continuously increase the long-term value of our organization by outperforming our industry peers and fostering a culture of underwriting and claims excellence.

AF Group (Lansing, Mich.) and its subsidiaries are a premier provider of innovative insurance solutions. Insurance policies may be issued by any of the following companies within AF Group:
Accident Fund Insurance Company of America, Accident Fund National Insurance Company, Accident Fund General Insurance Company, United Wisconsin Insurance Company, Third Coast Insurance Company, or Comp West Insurance Company.

Company:
AF Group

Location:

Lansing, USA

Level:
Non-Manager

Compensation:
Competitive Compensation and Benefits Package

Job Family:
Claims Processing

Industry:
Insurance Services

Responsible for all of the following duties Enterprise wide;
Analysis and entry of detailed payment data into the claim system for all states including manual states, contact with employers to obtain missing payment information or to clarify information submitted, issuance of non-indemnity and non-medical payments and manual payments, processing of refunds and transfers, handling route back checks for distribution, posting manual payments, research and resolution of returned non-medical checks.

Contacts include agents, policyholders, claimants, attorneys, and other Claims Department and Service Center staff.

• Review payment requests to ensure compliance with the Workers Compensation regulations.
• Contact policyholder for payment clarification and to obtain necessary information.
• Verifies, calculates, and pays approved injured worker travel and miscellaneous expenses.
• Stops and voids payment checks as requested.
• Sorts and distributes checks as requested.
• Validates, investigates and completes refund and transfer documents.
• Analyzes, validates, approves and processes attorney, legal, IME, vocational rehabilitation, medical management and all other vendor invoices.
• Contacts agents, policyholders, and injured workers to verify or gather claim information.
• Prepares form letters and composes general correspondence.
• Alerts Claim Handlers on reserve deficiencies.
• Participates on projects as requested.
• Post Excess & TPA Payments to claim files.
• Post internal claim costs.
• Post manual payments.
• Provides assistance as a Subject Matter Expert for procedures and workflow documentation.
• Prepares form letters and composes general correspondence.
• Review payment requests to ensure compliance with the Workers Compensation regulations.
• Contact policyholder for payment clarification and to obtain necessary information.
• Verifies, calculates, and pays approved injured worker travel and miscellaneous expenses.
• Stops and voids payment checks as requested.
• Sorts and distributes checks as requested.
• Validates, investigates and completes refund and transfer documents.
• Analyzes, validates, approves and processes attorney, legal, IME, vocational rehabilitation, medical management and all other vendor invoices.
• Contacts agents, policyholders, and injured workers to verify or gather claim…