What are the responsibilities and job description for the Claims Administrator position at LegalEASE, A Legal Access Company?
Benefits:
Job Description: Claims Administrator
Classification: Not Exempt
Reports to: Claims Director
Job Description
The claims administrator is responsible for assisting with the intake and processing of claims accurately and in a timely manner, as well as any related duties or tasks with a primary focus on assisting with the adjudication of claims.
This role will be part of the Claims Department, reporting to the Director of Claims. This department is primarily responsible for the overall claims process including claims intake/setup, sending closed claims statements and handling claims.
Essential Functions
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
While performing the duties of this job, the employee is regularly required to speak or hear. The employee frequently is required to stand, walk, use hands to finger, handle or feel, and reach with hands and arms.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Position Type and Expected Hours of Work
This is a full-time position. The basic expectation is 40 hours worked per week.
Travel
Limited travel might be expected for this position (less than 10%) for in office training.
Additional Eligibility Qualifications
None for this position
Work Authorization/Security Clearance
Please note that a criminal background investigation is conducted on every Legal Access Plans employee.
All job requirements are subject to possible modification to reasonably accommodate individuals with disabilities. Some requirements may exclude individuals who pose a direct threat or significant risk to the health and safety of themselves or other employees.
AAP/EEO Statement
Legal Access Plans is an equal opportunity employer.
Other Duties
The above job description is meant to describe the general nature and level of work being performed; it is not intended to be construed as an exhaustive list of all responsibilities, duties and skills required for the position. This job description in no way states or implies that these are the only duties to be performed by the employee occupying this position. Employees will be required to follow any other job-related instructions and to perform other job-related duties requested by their supervisor in compliance with Federal and State Laws. Requirements are representative of minimum levels of knowledge, skills and/or abilities. To perform this job successfully, the employee must possess the abilities or aptitudes to perform each duty proficiently. Continued employment remains on an “at-will” basis.
- 401(k)
- 401(k) matching
- Employee discounts
- Free food & snacks
- Paid time off
- Vision insurance
- Wellness resources
Job Description: Claims Administrator
Classification: Not Exempt
Reports to: Claims Director
Job Description
The claims administrator is responsible for assisting with the intake and processing of claims accurately and in a timely manner, as well as any related duties or tasks with a primary focus on assisting with the adjudication of claims.
This role will be part of the Claims Department, reporting to the Director of Claims. This department is primarily responsible for the overall claims process including claims intake/setup, sending closed claims statements and handling claims.
Essential Functions
- Preparation of in-network and out of network claims submitted by attorneys and members.
- Generating/sending closed case statements (ccs) forms per request from attorneys.
- Following up with attorney network providers or members for additional required information or clarification as needed.
- Communicate effectively, professionally and enthusiastically with internal/external clients, colleague and leadership.
- Consistently perform duties assigned with a sense of urgency and accuracy
- Accept personal responsibility for your tasks and actions. Following through with contacts and other tasks assigned.
- Respond to all phone messages and emails within 24 hours/same day.
- Complete job requirements in a manner consistent with the core values of LegalEASE.
- Maintain in-depth working knowledge of Legal Access Plans systems and processes.
- Performs other related duties as assigned.
- Bachelor’s Degree preferred (or higher)
- Must demonstrate sound judgement and decision-making in performing day to day activities
- Proficient in Microsoft Excel with demonstrated experience
- Must have strong analytical and problem solving skills
- Must plan work appropriately and balance multiple priorities
- Excellent communication skills, both written and verbal
- Must maintain the highest level of professionalism
- Strong working knowledge of Microsoft Office Suite
- Strong organization skills
- Strong attention to detail
- 2-5 years of direct or comparable experience in customer service, insurance, or account management
- Previous experience in a cross-company collaboration and partnership. Work closely with internal business partners and key members of the organization.
- Problem Solving: Need to evaluate and solve complex problems. Skillful handling and resolution of sensitive issues. Quick decision-making ability to recognize and decide the most effective course of action in a complex and changing environment.
- Technology: Able to proficiently utilize Microsoft Office, Smartsheet and the company’s systems and databases
- Strong verbal and written/documentation skills with the ability to communicate with and adapt to diverse individuals (internal or external to the company).
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
While performing the duties of this job, the employee is regularly required to speak or hear. The employee frequently is required to stand, walk, use hands to finger, handle or feel, and reach with hands and arms.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Position Type and Expected Hours of Work
This is a full-time position. The basic expectation is 40 hours worked per week.
Travel
Limited travel might be expected for this position (less than 10%) for in office training.
Additional Eligibility Qualifications
None for this position
Work Authorization/Security Clearance
Please note that a criminal background investigation is conducted on every Legal Access Plans employee.
All job requirements are subject to possible modification to reasonably accommodate individuals with disabilities. Some requirements may exclude individuals who pose a direct threat or significant risk to the health and safety of themselves or other employees.
AAP/EEO Statement
Legal Access Plans is an equal opportunity employer.
Other Duties
The above job description is meant to describe the general nature and level of work being performed; it is not intended to be construed as an exhaustive list of all responsibilities, duties and skills required for the position. This job description in no way states or implies that these are the only duties to be performed by the employee occupying this position. Employees will be required to follow any other job-related instructions and to perform other job-related duties requested by their supervisor in compliance with Federal and State Laws. Requirements are representative of minimum levels of knowledge, skills and/or abilities. To perform this job successfully, the employee must possess the abilities or aptitudes to perform each duty proficiently. Continued employment remains on an “at-will” basis.
