Claim Assistant - Remote

AF - Group; United States; On-site; USD 39,000 - 66,000; Full time

Job summary

AF - Group in the United States is seeking a detail-oriented administrative assistant to support the claims team. You will handle data entry, process medical billing computations, verify claim status, and assist in account management and file reviews.

The role emphasizes strong communication, organization, and the ability to manage multiple priorities in a fast-paced environment. Prior insurance experience is a plus.

Qualifications

• High school diploma or GED required with 2 years administrative experience.
• Experience in insurance environments and workers' compensation knowledge preferred.
• Strong communication and organizational abilities essential.
• Proficiency with MS Word and Excel; accurate data entry and verification.

Responsibilities

• Support customer service for the multi-functional claims team.
• Answer general claim inquiries and verify claim status.
• Communicate with team to ensure timely handling of claims.
• Assist in account management for the team's book of business.
• Compute payments for medical bills related to accidents per state rules.
• Provide administrative support using word processing and spreadsheets.
• Ensure payments are accurate and files closed per standards.
• Adhere to ethical conduct and perform other duties as required.

Skills

Independent worker

Communication skills

Customer service

Multitasking

Windows proficiency

Attention to detail

Data entry

Education

High school diploma or GED

Administrative experience (2+ years)

Insurance coursework

Certification encouraged

Tools

Microsoft Windows

Microsoft Word

Microsoft Excel

Office suite

Insurance claim system

Job description

Job Description

SUMMARY

The primary focus of this position is to provide support to the Claim Team. This includes but is not limited to returning phone calls, creating notes in system, closing claim files, and assisting in preparation of file reviews as well as other miscellaneous support activities. Computes medical bills associated with accidents and ensures timely payment.

Responsibilities/Tasks

• Supports the customer service work and processes for the multi-functional claims team.
• Answers general claim inquiries from providers and provide verification of claim status.
• Communicates and collaborates with team members to ensure the appropriate and timely handling of claims. Supports the team as required.
• Supports the account management process appropriately for the team's book of business.
• Computes the proper payment for the medical bills for non-indemnity and simple indemnity claims directly associated with the accident or activity.Computation is based on knowledge of the treatment given the individual and its relationship to the injury to relieve and/or cure the injury sustained as well as workers’ compensation provisions in the state the employer is domiciled.
• Provides administrative support to the Claims Department using word processing and spreadsheet applications. (Lien letters, timelines for medical treatment/events, etc.)
• Ensures that all payments are made in an accurate and timely manner and that all files are closed to meet internal performance standards while complying with state legislation to avoid penalties and reduce the amount of supplemental bills.
• Adheres to the Employee Code of Ethical Conduct.
• Completes other duties and special projects as requested

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

Employment Qualifications

EDUCATION OR EQUIVALENT EXPERIENCE

High school diploma or G.E.D required. College coursework in English, Mathematics, Business Administration or Administrative Management OR the equivalent in insurance-related course work and experience is required. At least 2 years of administrative experience. Continuous learning required, as defined by the Company’s learning philosophy. Certification, or progress toward, highly preferred and encouraged.

Experience

Previous experience in an insurance environment or previous knowledge of workers' compensation laws is desired. Knowledge of medical terminology is preferred.

Skills/Knowledge/Abilities (ska) Required

• Ability to work independently as well as in a multifunctional business unit is essential.
• Effective oral and written communication skills are essential.
• Excellent customer service and organizational skills are essential.
• Ability to manage multiple priorities and adapt to changing workflow in order to still meet deadlines and goals are essential.
• Proficient in Microsoft Windows
• Attention to detail and analytical skills required.
• Ability to enter and verify alpha/numeric data accurately.

Working Conditions

Work is performed in an office setting with no unusual hazards.

Pay Range

Actual compensation decision relies on the consideration of internal equity, candidate’s skills and professional experience, geographic location, market, and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $39,100 and $65,600.

The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description.

We are an Equal Opportunity Employer. Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at-will" basis. Nothing herein is intended to create a contract.

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