What are the responsibilities and job description for the Claim Support Specialist position at A-G Specialty Insurance, LLC?
A-G Specialty Insurance, LLC designs, markets and underwrites specialty sports, accident, and general liability insurance products. We have been in operation since 1983 and are nationally recognized as a leader in the sports insurance industry.
Job Summary
As a Claim Support Specialist, the incumbent will play a vital role supporting our Claim Services team. This role will involve administrative duties that are outlined below, to which is vital to the success of the claims process and will add efficiencies to the claims adjudication workflow as well as customer, client and provider satisfaction. The ideal candidate should be highly detail-oriented, precise, able to problem solve, as well as follow and interpret guidelines and requirements.
Essential Duties & Functions
Reasonable accommodations may be made to enable individuals to perform the essential functions.
- Attach policies for new claims and conducting coverage reviews
- Update claim detail data
- Operate from the Smart Data Solutions (SDS) portal when needed
- Creation of new claims and rollover claims; including but not limited to mandatory student accident policies (MSAP), and Intercollegiate Sports (ICS) policies
- Manage electronic incoming submissions and alternative workflows
- Retrieve necessary documentation for specific claims; including but not limited to itemized bills and explanation of benefits (EOBs)
- Open document clean-up in EGBAR (OAND report clean-up)
- Input provider Tax IDs in EGBAR
- Assist in response to A-G customer inquiries
- Generate payments for new claims
- Prep files for carrier audits
- Create database of provider contacts
- Other duties as assigned by manager or supervisor as related to the support of the Claims team.
Job Skills
- Team Player
- Excellent verbal and written communication
- Prioritize tasks appropriately and maintain organization
- Advanced critical thinking and problem-solving skills
- Strong decision-making ability and sound judgement
- Build client relationships
- Self-starter and self-disciplined in accomplishing tasks
Job Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Required/Preferred Education and Experience
Required Education: High School Diploma or Equivalent Experience
Preferred Experience: 1-3 years insurance experience, medical billing/coding experience, document management experience, customer service experience
Work Environment
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and scanners.
Position Type and Expected Hours of Work
This is a full-time position. Days and hours of work are Monday through Friday, 8:30 a.m. to 5 p.m. The schedule for this role can be contingent upon Supervisor and Human Resources approval. Some evening and weekend work may be required.
Travel
Travel to the office may be expected for this position.
