Claim Operations Specialist

Jobtailor; Saint Paul (MN); On-site; USD 42,000 - 56,000; Full time

Job summary

Jobtailor is seeking a customer service representative for its claims department in Minnesota. The role involves serving clients, triaging calls, and responding to claim status and payment inquiries.

You'll collaborate with claim professionals to ensure timely resolutions, document files, and process reports, mails, and payments while maintaining strong data accuracy and records management.

Qualifications

• High School Diploma or GED required.
• 1 year of service-related work experience OR Bachelor's Degree.
• Proficient in Microsoft Office, e-mail, Web-enabled applications, and database software.
• Strong verbal and written communication skills.
• Ability to lift items up to 20 pounds occasionally.

Responsibilities

• Serve as a customer service representative for the claim department.
• Triage and route callers to the appropriate department.
• Answer claim status and payment questions.
• Partner with claim professionals to assist with timely claim resolution.
• Document claim files, including notes and diaries.
• Request reports and records and review medical bills, mail, and wage statements.
• Prepare claim documents for legal and medical reviews.
• Report and assign claims and transition closed files to and from off-site storage.
• Receive, sort, scan, upload, and process incoming and outgoing mail.

Skills

Customer Service Representation

Claims Processing

Data Analysis

Microsoft Office Proficiency

Verbal And Written Communication

Education

High School Diploma

GED

Tools

Database Software

Web-Enabled Applications

Email

Job description

• Serve as a customer service representative for the claim department
• Triage and route callers to the appropriate department
• Answer claim status and payment questions
• Partner with claim professionals to assist with timely claim resolution
• Document claim files, including notes and diaries
• Request reports and records and review medical bills, mail, and wage statements
• Prepare claim documents for legal and medical reviews
• Report and assign claims and transition closed files to and from off-site storage
• Receive, sort, scan, upload, and process incoming and outgoing mail
• Order, receive, and distribute supplies and/or equipment
• Process and issue claim payments, vendor invoices, attorney expenses, and medical processing fees
• Process and document returned checks, voided checks, and credits
• Prepare, generate, and review operational, line-of-business, and financial reports
• Update data discrepancies in reports and systems
• Document pending and completed work activities
• Perform underlying financial controls and communicate findings
• Assess data reasonableness, identify discrepancies, perform reconciliations, and assess financial controls
• Prepare data entries according to established standards
• Perform other duties as assigned

Requirements

• High School Diploma or GED
• 1 year of service-related work experience OR Bachelor's Degree
• Experience utilizing Microsoft Office, e-mail, Web-enabled applications, and database software
• Ability to analyze and compare information to understand issues and explore alternative solutions
• Verbal and written communication skills
• Ability to exercise sound judgment and make decisions
• Ability to build and maintain productive working relationships
• May require lifting items up to 20 pounds occasionally

Core Competencies

Demonstrates strong customer service skills while effectively managing claims processing and documentation. Proficient in data analysis, financial reporting, and maintaining accurate records to support timely claim resolution.

Highest-signal resume keywords

• Customer Service Representation
• Claims Processing
• Data Analysis
• Microsoft Office Proficiency
• Verbal And Written Communication

ATS Optimization Keywords

Hard Skills

• Claims Documentation
• Financial Reporting
• Data Entry
• Reconciliation
• Medical Bill Review

Soft Skills

• Sound Judgment
• Decision Making
• Relationship Building

Certifications & Qualifications

• High School Diploma
• GED

Industry Keywords

• Claim Status
• Claim Payments
• Operational Reports
• Vendor Invoices
• Financial Controls

Tools & Technologies

• Database Software
• Web-Enabled Applications
• Email