Claims Assistant

1. Summary:

Under the supervision of the Claims Manager, a Claims Assistant performs secretarial, administrative and audit functions for the Claims Department, including preparing and filing correspondence, generating claims reports, updating claims records, and addressing claims inquiries. The Claims Assistant serves as a back-up to the Claims Administrative Specialist, the Claims Intake Department, and front desk/reception, as needed.

2. Functions:

a. Serves as a back-up to the Claims Administrative Specialist during lunch breaks, employee leave periods, etc.;

b. Responsible for scheduling medical appointments and following up for all duty determination (DDI) information forms;

c. Ensures signed medical authorization forms have been received from all workers’ compensation claimants and follows-up as appropriate to obtain any signed medical authorization forms that are missing;

d. Follows-up with medical providers regarding billing issues, including making inquiries regarding overdue balances and appropriately resolving any such billing issues;

e. Ensures that the statement and collection notice policies in the Claims Procedural Manual and Claims Accounting procedures are followed;

f. Schedules medical exams, sets-up physical therapy appointments and diagnostic studies, as requested by claims staff;

g. Ensures that NJSIG’s managed care organization receives all of the necessary claims information for new claims, and inputs any missing claims information;

h. Regularly reviews, monitors and updates the Intake Unit’s member contact database for any new lines of coverage, new members, new locations, and/or new sub-locations, as reflected in the DAAG;

i. Coordinates in-office meetings at the request of the Executive Director, which includes reserving appropriate meeting space, advising reception of expected guests, organizing food and beverage catering when necessary, directing guests to the meeting space, providing guests with water, coffee, etc. upon arrival, etc.;

j. Acts as a back-up to the receptionist during lunch breaks, employee leave periods, etc. for deliveries, incoming calls, checking inventory and placing orders for staff requests.

k. Orders name plates for new NJSIG employees and as needed for existing employees;

l. Assembles workers’ compensation packets, posters, cards and letters for distribution to members;

m. Acts as a back-up to the Claims Intake Department during lunch breaks, employee leave periods, etc., by taking phone calls, returning messages, and monitoring the Intake portal and all fax submissions;

n. Prepares and composes routine and complex correspondence including letters, memoranda, emails, reports, as requested;

o. Develops and maintains written procedures and systems to perform all administrative functions efficiently;

p. Assists with greeting and welcoming guests, answering phone calls, and facilitating the prompt and accurate dissemination of messages and phone calls to NJSIG staff;

q. Assists with receiving letters, packages, e.g., and alerting mailroom of deliveries;

r. Monitors office and facility supplies and reorders same as needed, within budget; assists in making other office purchases, as requested;

s. Exhibits excellent member services skills, including telephone and personal contact with members, workers’ compensation claimants, and other callers;

t. Returns phone calls related to online submissions for the Intake Department, as directed by the Claims Intake Representative III;

u. Ensures the Claims Dashboard is monitored for all First Reports of Injury (FROI’s) and inputs any new FROI’s;

v. Enters all new member locations and sub-locations into electronic database; and

w. Assists with special projects, as necessary.

3. Qualifications:

a. High school diploma, General Educational Development certificate or state authorized high school equivalent certificate required, Associate’s Degree in Business Administration, Finance or Accounting preferred;

b. Minimum of one year of experience in a clerical support position required, experience in a secretarial capacity preferred;

c. Knowledge of the Microsoft Office suite of products required;

d. Ability to work in an office environment with moderate noise level, ability to work flexible hours, including evenings and weekends, and the ability to travel to other offices and client, carrier, and work sites, as required;

e. Strong communication and organizational skills required; and

f. Residency in the State of New Jersey in accordance with the New Jersey First Act, N.J.S.A. 52:14-7, et seq., unless otherwise exempted

Salary : $37,167.00 - $48,550.00 (Min - Mid)

Job Type: Full-time

Pay: $37,167.00 - $48,550.00 per year

Benefits:

• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Work Location: Hybrid remote in Mount Laurel, NJ 08054

Salary : $37,167 - $48,550