Claims Clerk Part-Time

Summary: The claims clerk would support the Claims Department and work within the TPL/COB Team.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Works on site with consistent attendance. 
• Provider Adds: works form a queue for the editing and addition of Providers into the Provider Master File and its relevant data files to ensure the processing of claims for the Claims Department.
• Provider Gateway Support: Will support the registration process of the Provider Gateway system currently in place and monitored/managed by the TPL/COB Team, to include: monitoring of the communications of the “pending registrations” for Providers attempting to complete their information and manage online queries for status by same.
• COB Follow-Up Notices: May assist in the support of reviewing current list of Notices (by date) and printing-packaging-sending Coordination of Benefit “Reminder” Notices
• Returned Check Log: Support / Maintain log of checks returned to BRMS for “bad address.” This log is viewed by Accounting – Customer Support and requires follow-up action when a corrected set of information is received. ACTION is required to investigate possible “new addresses” for revision. Working with Provider Specialist is key relationship in this task.
• Other duties as may be required in support of the Claims Department, as may be needed.

Supervisory Responsibilities: This job has no supervisory responsibilities.

Knowledge, Skills, & Abilities:

• Strict attention to detail.
• Critical thinking
• Passion to resolve issues – “things that don’t make sense” without rejecting.
• Not afraid to question anything that seems off……

Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience: None required

Language Skills: Ability to read, speak, and write effectively in English. 

Mathematical Skills: Ability to add and subtract figures.

Reasoning Ability: Ability to apply common sense understanding to carry out instructions furnished in written & oral form.

Certificates, Licenses, Registrations: None.

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. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job, the employee is regularly required to sit for extended periods in front of a computer. The employee is frequently required to reach with hands and arms and talk or hear. The employee is occasionally required to stand; walk and use hands to finger, handle, or feel.

Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually moderate.