Claims Assistant

Jobtailor; Illinois; On-site; USD 42,000 - 56,000; Full time

Job summary

Jobtailor in Illinois seeks an organized claims processor to manage digital records, maintain maintenance checklists, and support the worker's compensation team with data accuracy and timely processing.

The role requires 1–2 years of claims processing experience, strong communication skills, and proficiency with ImageRight and Powersuite. College degree preferred; HS diploma required.

Qualifications

• High school diploma or equivalent required.
• College degree preferred.
• 1–2 years of claims processing experience preferred, worker's compensation.
• Strong knowledge of workers’ compensation claims procedures.
• Professional telephone demeanor and good verbal and written communication.
• Strong organizational skills.
• Typing speed of 45 WPM.
• Basic understanding of business technology.

Responsibilities

• Organizes digital claim records for uniformity by removing duplicates and top-lining documents.
• Completes 10-day and 6-month claim maintenance checklists to ensure data accuracy and processing.
• Processes corrections to data error crits as required.
• Completes manual Medicare query of claims and documents the digital claim record.
• Processes class code corrections to accurately depict job and payroll scope.
• Completes claim documents in ImageRight and Powersuite.
• Handles closure, re-open, and reassignments of all claim files as submitted by Supervisory personnel.
• Assists with record subpoenas and completes lien reviews with worksheet summary.
• Completes vendor referrals by service specialty and utilization review submissions.
• Maintains contact with the WCAB for status updates on claims where named as a party to suit in error.
• Complies with IMR responses for timely fulfillment.
• Reviews adjuster ImageRight tasks daily for medical authorization requests.
• Provides administrative assistance to claim adjusting team members as needed.
• Provides back-up in the entry of manual payments to the Claims Payable Analyst.

Skills

Claims processing

Attention to detail

Verbal communication

Written communication

Typing 45 WPM

Organization skills

Data entry

Education

High school diploma

College degree preferred

Tools

ImageRight

Powersuite

Job description

Responsibilities

• Organizes the digital claim records for uniformity by removing duplicate records and top-lining documents
• Completes 10-day and 6-month claim maintenance checklists to ensure the highest level of claims statistical data processing
• Processes corrections to data error crits as required
• Completes manual Medicare query of claims at the CMS COB&R site as needed and documents the digital claim record
• Processes class code corrections that accurately depict the scope of an injured workers’ job and payroll
• Completes claim documents in both ImageRight and Powersuite
• Completes closure, re-opens, and reassignments of all claim files as submitted by Supervisory personnel
• Assists with record subpoenas and completes lien reviews organized with a worksheet summary
• Completes vendor referrals by service specialty and utilization review submissions to Rising
• Maintains contact with the WCAB for status updates on claims where named as a party to suit in error
• Complies with Maximus responses following IMR for timely fulfillment
• Reviews adjuster ImageRight tasks daily for medical authorization requests
• Provides administrative assistance to claim adjusting team members as needed
• Provides back-up in the entry of manual payments to the Claims Payable Analyst

Requirements

• Minimum Education: High School Diploma or equivalent
• Preferred Education: College degree preferred
• 1-2 years of relevant claims processing experience preferable in the worker’s compensation field or similar experience
• Thorough knowledge of workers’ compensation claims procedures and policies
• Professional telephone demeanor, good verbal and written communication skills, good listening skills
• Strong organizational skills
• Ability to type 45 WPM
• Basic understanding of business technology