Claims Intake & Resolution Specialist

Emergent Holdings, Inc.; Lansing (MI); On-site; USD 42,000 - 64,000; Full time

Job summary

Emergent Holdings, Inc. is seeking a claims intake specialist to maintain incoming workload, resolve issues, and process first report of injury (FROI) and first notice of injury (FNOI) submissions.

You will determine jurisdiction from multiple sources and route to the correct destination while handling priority requests and updates to existing claims. The role requires strong attention to detail, two years of office experience, and proficient communication skills.

Qualifications

• High school diploma or GED required; combination may be considered.
• Minimum of two years of general office experience, including customer service.
• Experience with document management systems and basic computer knowledge.
• Excellent verbal and written communication skills.

Responsibilities

• Identify jurisdiction, date of injury and handling items; research and re-index non-new submissions to route to appropriate handling.
• Receive incoming general new claims calls for all entities; backup for calls if telephone system shutdown.
• Make changes and updates on newly created or existing claims; guide end-users on processes.
• Serve as resource for intake-related issues; determine jurisdiction and help in finding coverage or information.
• May participate in training employees new to the role.
• Process Workers’ Compensation claims from Open Pool queues or via telephone; code body part, diagnosis and cause of injury; review for accuracy.
• Confirm policy coverage for date of injury, business location and injury location; request policy updates as needed.
• Maintain department procedures and workflows; may create new workflows.
• Research state and internal systems; route mail to appropriate region/department; forward unidentified mail with form letters.
• Route documents to medical bill review vendor.

Skills

Customer service

Communication

Data entry

Organization

Multi-tasking

Training others

Phone etiquette

Education

High school diploma or GED

Tools

Excel

Word

Document management system

Job description

Emergent Holdings, Inc. is seeking a claims intake specialist to maintain incoming workload, resolve issues, and process first report of injury (FROI) and first notice of injury (FNOI) submissions.

You will determine jurisdiction from multiple sources and route to the correct destination while handling priority requests and updates to existing claims. The role requires strong attention to detail, two years of office experience, and proficient communication skills.