- Handles lower-level liability and/or physical damage claims under close supervision.
- Supports other claims representatives, examiners and leads with larger or more complex claims as necessary.
- Processes general liability claims determining compensability and benefits due; monitors reserve accuracy, and files necessary documentation with state agency.
- Communicates claim action/processing with claimant, client and appropriate medical contact.
- Ensures claim files are properly documented and claims coding is correct.
- May process routine payments and prescriptions and status reports for lifetime medical claims and/or defined period medical claims.
- Maintains professional client relationships, performs other duties as assigned and supports the organization's quality program(s).
Requirements
- High School Diploma or GED required.
- One (1) year of general office experience or equivalent combination of education and experience required.
- Claims industry experience preferred.
Core Competencies
Demonstrates proficiency in processing general liability claims, ensuring accurate documentation and coding, while maintaining professional relationships with clients and stakeholders. Capable of supporting complex claims and contributing to the organization's quality programs.
Highest-signal resume keywords
- Claims Processing
- Documentation Accuracy
- Client Communication
- General Office Experience
- Claims Industry Experience
ATS Optimization Keywords
Hard Skills
- Claims Coding
- Compensability Determination
- Reserve Monitoring
- Payment Processing
- Medical Claims Management
Soft Skills
- Professional Relationship Management
- Team Support
Certifications & Qualifications
Industry Keywords
- Liability Claims
- Physical Damage Claims
- Claims Representatives
- Claims Examiners