Claims Document Analyst

SUMMARY:

Primarily responsible for supporting the management of the claim files by analyzing, indexing, re-indexing, and assigning a sub document type to all documents received by the Claims Departments within the Enterprise. Also responsible for identifying key information on documents and inputting information into the keywords of the document and in the appropriate data fields in the claim system.

PRIMARY RESPONSIBILITIES:

· Analyzes incoming documents and assigns the appropriate document sub type to them

· Reviews each document and adds pertinent information to the document keywords and to appropriate data fields in the claim system

· Re-indexes and appropriately routes documents that have been assigned an improper document type or have been attached to an incorrect claim

· Sets priority activities to claim handlers as appropriate upon receipt and review of documents

· Performs other duties and special projects as requested.

· Assists with the creation of procedural documentation and workflows.

This description identifies the responsibilities typically associated with the performance of the job. The percentage of time in any responsibility may vary between positions. Other relevant essential functions may be required.

EMPLOYMENT QUALIFICATIONS:

A. EDUCATION REQUIRED:

High school diploma or G.E.D required with additional training or college-level course work in business or insurance. Combinations of education and experience may be considered in lieu of additional training or coursework.

B. EXPERIENCE REQUIRED:

Minimum two years general office experience that includes previous relevant experience reviewing and providing specific document types to scanned images.

C. SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:

· Excellent verbal and written communication skills.

· Excellent customer service skills.

· Basic knowledge of computers and spreadsheet software.

· Basic knowledge of word processing software.

· Ability to proofread correspondence for accuracy of spelling, grammar, punctuation, and format.

· Ability to work effectively with various business units.

· Ability to be an independent thinker to solve issues.

· Ability to manage multiple priorities and meet established deadlines.

· Excellent organizational skills and ability to prioritize work.

· Ability to verify data for accuracy.

· Knowledge of medical terminology.

· Knowledge of legal terminology.

· Ability to train and coach others to perform the core responsibilities.

· Ability to assist with the creation of procedural documentation and workflows.

· Knowledge of multi-functional telephone system.

· Ability to multi-task i.e. interacts on telephone while entering data

D. ADDITIONAL EDUCATION, EXPERIENCE, SKILLS, KNOWLEDGE AND/OR ABILITIES PREFERRED:

· Previous experience in the workers’ compensation field.

· Previous experience with medical records, medical terminology and administrative support.

· Experience working with scanned images/document management system.

· Experience with state/legal documents.

· Insurance Institute of America (IIA) Certification Experience in Workers’ Compensation Claims Processing.

WORKING CONDITIONS:

Work is performed in an office setting with no unusual hazards.

REQUIRED TESTING:

Basic Windows, Basic Excel, Basic Word, proofreading, Alpha Numeric