What are the responsibilities and job description for the Claims Medical Support Specialist position at Amwins Global Risks?
Position: Claims Medical Support Specialist Location: Metairie, LA Job Id: 5151 # of Openings: 0
Company Summary
The American Equity Underwriters, Inc. (AEU) (An Amwins company) is the program administrator of the American Longshore Mutual Association, Ltd. (ALMA), a group self-insurance fund authorized by the U.S. Department of Labor to provide USL&H coverage for the liabilities of its members under the United States Longshore & Harbor Workers’ Compensation Act.
With decades of experience in the maritime industry and a strong commitment to our members, AEU is the leading specialist in USL&H. We have helped make safety a priority for waterfront employers for more than 20 years — and we’re determined to help our members continually reduce risks for the benefit of their employees and our industry as a whole.
Position Summary
The Claims Medical Support Specialist position is responsible for providing administrative support to staff and customers regarding claims-related inquires and requests.
Job Responsibilities
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Company Summary
The American Equity Underwriters, Inc. (AEU) (An Amwins company) is the program administrator of the American Longshore Mutual Association, Ltd. (ALMA), a group self-insurance fund authorized by the U.S. Department of Labor to provide USL&H coverage for the liabilities of its members under the United States Longshore & Harbor Workers’ Compensation Act.
With decades of experience in the maritime industry and a strong commitment to our members, AEU is the leading specialist in USL&H. We have helped make safety a priority for waterfront employers for more than 20 years — and we’re determined to help our members continually reduce risks for the benefit of their employees and our industry as a whole.
Position Summary
The Claims Medical Support Specialist position is responsible for providing administrative support to staff and customers regarding claims-related inquires and requests.
Job Responsibilities
- Generate various system reports
- Ensure vendor data is accurate and up to date in claims management system (CMS)
- Create and modify various documents using Microsoft Office and other required software.
- Process incoming mail and scan/file/distribute as appropriate
- Prepare and ship carrier packages
- Submit request for injuries to client
- Document and record received claims information to appropriate claim in CMS
- Effectively communicate with internal and external parties by responding in a professional and timely manner and providing them with clear and concise information until their inquiries are resolved
- Review and have a full understanding of the organization’s medical management policies and procedures as they relate to specific medical billing specialist workflows and tasks
- Compile medical bills received and submit them to the medical bill review partner with urgency and efficiency
- Assemble medical records in preparation for a medical-legal review or medical second opinion
- Monitor medical bill processing to ensure the required authorization is performed in a timely and accurate manner
- Responsible for answering the claims team's questions related to medical bill status
- Maintain an ongoing list of medical bills or invoices received where a claim cannot be found
- Obtain medical records from provider offices or facilities as requested by the claims or medical management nurse team
- Attend regular team/department meetings and actively participant in discussions
- Assist with medical bill or vendor invoice reconciliation projects, or other related projects as needed
- Medical managed care and/or medical billing experience preferred
- Knowledge of diseases, injuries, and medical terminology a plus
- Proficiency with Microsoft Office software: Outlook, Excel, and Word
- Excellent communication skills, both verbal and written
- Possess strong sense of accountability and pride
- Demonstrate outstanding problem-solving, critical thinking, and organizational abilities
- Comfortable working autonomously with given roles and responsibilities
- High school diploma, GED required
- Employees enjoy a comfortable working environment in a modern-classic office space with beautiful views
- Named one of the Best Companies to Work for in Alabama for five years straight
- Collaborative, positive, and engaging company culture
- Strong tradition of corporate charitable promotion
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