What are the responsibilities and job description for the Claims Support Specialist position at Amwins Group, Inc.?
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 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
QUALIFICATIONS AND SKILLS
- 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
WORKING ENVIRONMENT
- 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
