Claim Processing Representative

Responsibilities

• Process entry-level and intermediate claims with a 99% or greater accuracy rate
• Adhere to approved claim workflow requirements to maximize efficiency
• Serve as backup to Claim Administration team for entry-level adjustments to claims as necessary
• Serve as back up to call center during peak periods by taking provider and member calls
• Successfully complete basic claim-related projects

• Associate's degree or two years of experience in a business environment
• Strong math competency
• Ability to efficiently operate computer
• Strong interpersonal, written and verbal communication skills
• Attention to detail, accuracy and organization skills
• Self‑motivation demonstrated by a readiness to learn more and assume new challenges
• Cooperative, professional, and effective interaction skills with co‑workers, business partners, and visitors
• Ability to work in excess of 40 hours in one week
• Ability to use Microsoft Office (Word, Excel and Outlook)
• Understanding of general insurance principles
• Able to follow verbal and written instructions
• Ability to read and comprehend at a high school level
• Required to attend additional training as requested/deemed necessary
• Previous claim processing experience is a plus

• Claims Processing
• Math Competency
• Computer Operation
• Microsoft Word
• Microsoft Excel
• Microsoft Outlook
• Insurance Principles

• Attention to Detail
• Self‑Motivation
• Cooperative Interaction
• Organizational Skills
• Effective Communication