Claims Operations Support
Assist with claims administration, including claim file setup, assignment support, tracking timeliness, and completing claims-related tasks as assigned.
Scan, index, and route claims documents and correspondence in accordance with records management and retention requirements.
Prepare, process, and mail claims-related letters, forms, and materials as required.
Answer claims-related calls only, providing basic information within established guidelines and routing or escalating issues appropriately.
Serve as liaison support between the claims team and other internal business units (e.g., accounting) for claim-related data requests, documentation needs, and follow-up items.
Support annual independent audits, regulatory examinations, and periodic data calls by compiling and validating claims documentation and reports.
Documentation, Accuracy, and Compliance
Maintain accurate and well-documented claim files, ensuring that actions, correspondence, and supporting materials are properly recorded.
Follow written procedures, internal controls, and compliance requirements related to claims handling and documentation.
Identify missing, inconsistent, or unclear information and escalate issues appropriately.
Requirements
Required
High school diploma or equivalent; some college preferred.
3+ years of experience in claims administration, insurance operations, or a comparable professional office role with regulated workflows.
Strong written and verbal communication skills with the ability to document claim activity clearly and professionally.
Demonstrated attention to detail and accuracy in data entry, document handling, and recordkeeping.
Ability to manage multiple tasks, deadlines, and priorities in a claims-driven environment.
Proficiency with Office 365 (Outlook, Word, Excel).
Dependable attendance and consistent work history.
Preferred
Prior claims clerical, claims operations, or insurance carrier experience.
Experience supporting audits, regulatory reviews, or compliance-related data requests.
Familiarity with claims management systems and electronic document management practices.