NO FAULT PROCESSOR (Hybrid)

Hereford Insurance Company; New York (NY); Hybrid; USD 36,000 - 42,000; Full time

Job summary

Hereford Insurance Company in New York is seeking a Claims Support professional to assist busy claims teams with no fault-related tasks. The hybrid role requires two in-office days per week and involves processing forms, documenting claims, and supporting investigations.

You will prepare denials, maintain logs, and help generate production reports. A basic understanding of applicable regulations and litigation is expected, with growth in No Fault claims expertise.

Qualifications

• Basic but evolving knowledge of No Fault claims and applicable regulations and litigation.

Responsibilities

• Send initial and follow-up forms in compliance with regulations.
• Document incoming No Fault claims and assist in coverage issues.
• Prepare denials and delays.
• Prepare FTC denials, IME denials and blanket denials.
• Prepare peer denials.
• Set up new claims and assist investigations with coverage notes.
• Maintain mailing logs and generate production reports.
• Follow and maintain claim diaries; assist in various projects.

Skills

Wage claims

No Fault claims

Regulatory knowledge

Job description

Salary Range: $36,000.00 To $42,000.00 Annually

Support claims professionals in the performance of their job responsibilities.

• Send appropriate initial and follow up forms in compliance with applicable regulations including: o Wage claims, nf-2,3,4,5,6, 8 and 11
• Document incoming nf-2 and assist in the identification of coverage issues
• Preparation of denials and delays
• Prepare FTC denials, ime denials and blanket denials
• Prepare peer denials
• Timely set up new claims and assist in the completion of investigations including coverage notes
• Make appropriate inquiry to obtain additional information required to effectuate job responsibilities
• Timely complete and maintain mailing logs
• Maintain records and provide information to generate production reports
• Following and maintaining identified claim diaries
• Assist in various projects including file closings and data entry

Other Duties

• Assist in the process of six-month EOB’s.
• Assist in check request and preparation process.
• Fee Schedule NF billing.

This job description in no way states or implies that these are the only duties to be performed. You will be expected to follow any other job-related instructions and to perform other job-related duties as requested by your supervisor.

Qualifications

Basic but evolving knowledge of the applicable No Fault claims and applicable regulations and litigation.

*This is a hybrid position requiring 2 days in-office per week.