Claims Processing Clerk, Sr. jobs in Macon, GA

Claims Processing Clerk, Sr. receives and inputs new healthcare claims, processes payments, conducts billing research, and responds to telephone inquires. Evaluates claims and administers payment, denies, or returns claims according to policy provisions and organizational guidelines. Being a Claims Processing Clerk, Sr. produces routine and ad hoc reports. Requires a high school diploma. Additionally, Claims Processing Clerk, Sr. typically reports to a supervisor. The Claims Processing Clerk, Sr. works independently within established procedures associated with the specific job function. Has gained proficiency in multiple competencies relevant to the job. To be a Claims Processing Clerk, Sr. typically requires 3-5 years of related experience. (Copyright 2024 Salary.com)

Recently Added Claims Processing Clerk, Sr. jobs

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Claims Coordinator
  • ServiceMaster of Middle GA
  • Macon, GA FULL_TIME
  • Benefits:
    • 401(k)
    • Bonus based on performance
    • Competitive salary
    • Opportunity for advancement
    • Paid time off

    Claims Coordinator Job Description

    Reports To: Owner / Operations Manager |
    Consults With: Operations Manager, Office Manager |

    Department(s):  Emergency Services / Mitigation |


    Company Mission Statement:

    At Servicemaster of Middle Ga, We empower our team members by ensuring they have the tools and knowledge in order to make decisions and allowing them to lead rewarding fulfilling careers. 
    Our Core Values:
    1.Integrity First 
    2.Service before Self 
    3.Excellence in all we do


    Job Summary

    The claims coordinator position is vital in the organization. This role ensures the jobs run smoothly and is the liaison between the insurance company, our company and restoring the customer back to whole.


    Major Duties and Responsibilities
    Responsible for oversight of all claims functions from creation to close. 

    • Ensure all claims are entered correctly into Restore 365 and all required information and forms required are provided to technicians in order to prevent multiple trips. 
    • 24 hr scope notes & photos must be uploaded immediately on receipt and CAT/Class entered. 
    • Monitor programs consistently throughout the day to update service levels, upload all photos when sent by technicians, enter all updates in the notes. This includes Alacrity notes, MICA, Restore 365, and XACT. 
    • Ensure Compliance is at 100% green and documentation is required when it is not.
    • Obtain all approvals on jobs including but not limited to vendor documents, additional equipment required, dumpsters and pods and maintain detailed records of each for trackability and ITEL submissions. 
    • Find solutions for the issues with approvals and compliance questions as the subject matter expert on each claim. 
    • Review each open job daily and address adjuster requests while also communicating with the team of progress including notifying when bill needs to be generated or estimate completed. This includes photo reviews, paperwork, scope reviews. 
    • Ensure claim file is complete with final template added as a note in XACT, Itel, CX as well as Inspection form w/ scope prior to closing job.  
    Minor Duties and Responsibilities

    •  Assisting Office Manager when needed - Answering phones and handling customer issues as you will be the most aware of each claim.

    Required Attributes 

    • Must have a sense of urgency and a "Will do" attitude ready to jump in to assist the team. In the Emergency Services industry, we are not in control of when chaos ensues. 
    • Must be coachable and able to accept feedback with the knowledge it is provided to help you progress in your role.
    Key Competencies

    • Sense of Urgency 
    • Organized 
    • Proactive
    Daily Activity Log

    • Check compliances to ensure 100% green and address ANY issues complete with documentation or note in Restore as well as contacting parties to notify if waiting on materials from them. 
    • Ensure all updates for programs are communicated to the team.
    • Review the job board to see daily jobs as well as POC working at each. 
    • Go through ALL open jobs in Restore Alacrity, and XactAnalysis. 
    • Contact adjuster or claims handler if still pending approval to ensure they have everything required from us. This may require multiple calls and emails to track them down. You are the internal customer service that will have the most contact with adjusters. 
    • Add a daily update note in each with the status from us or request update for what is required for payment to be issued from insurance in XACT. (This note can be made in XACT and copy/paste in Restore but MUST be in Restore)
    • Ensure all documents including Estimate, Sketch and Scope are uploaded into Restore and organized within each file for the various jobs.
    • If the tech has uploaded documents in Mica, download the photos/docs and upload in restore before turning to yellow and create reports by uploading to Xactanalysis.
    • Check Mica and Contents Tracker to see if any info needed to complete tasks has been uploaded. Transfer to restore if necessary.
    • On day 2 or 3 if  there is nothing in MICA yet, start hounding that techs to get it uploaded
    • Check EVERY ATP, ATR, COS and waivers once Tech has uploaded to ensure the correct form was signed. If they got the wrong form signed this needs to be handled IMMEDIATELY 
    • Ensure documentation and tracking on ALL equipment/dumpsters/Pods for each job and that pick ups are communicated to the Mitigation Manager and Estimator. 
    • Submit Itel samples daily and ensure Itel samples are collected, and uploaded to proper program.
    • Ensure all scopes/ sketches are completed and scanned to estimator
    • Send reminder message to tech that COS must be signed when equipment is picked up
    • Verify all paperwork is correct by day 3-4 so that billing is not held up preventing 10 day cycle time being met.
    • Ensure email/ chat is monitored throughout the day with response/ acknowledgement within 30 mins of receipt.
     **When Claims Capture is sent, there will ONLY be an email notification before the compliance clock starts**

    • Input new claims in Restore and make sure all required fields are completed: 
    • Update Customer/Company info
    • Update job name
    • Internal Participants tab (Foreman, Coordinator, Estimator, Marketing)
    • External participants tab (Insurance Company, Adjuster)
    • Referred by (must be listed on every job)

    **Subject to change
  • 20 Days Ago
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S
Claims Coordinator
  • ServiceMaster Restore
  • Macon, GA FULL_TIME
  • Benefits: 401(k) Bonus based on performance Competitive salary Opportunity for advancement Paid time off Claims Coordinator Job Description Reports To: Owner / Operations Manager | Consults With: Oper...
  • 24 Days Ago
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C
Clerk
  • Community Health Care Systems, Inc.
  • Helena, GA FULL_TIME
  • Responsible for data entry of EMR charges and payment. Collects payment from patient, if necessary, and schedules follow-up appointment. Balances EMR billing system with cash drawer and closes out at ...
  • 20 Days Ago
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R
OC Labor Processing
  • ROSE ACRE FARMS INC
  • Madison, GA FULL_TIME
  • POSITION DESCRIPTION: Grader General Labor is responsible for inspecting and removing eggs with checks, bloods, dirts and leakers as they move through the candling booth, and properly packaging eggs o...
  • 2 Days Ago
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H
Sterile Processing Technician
  • Houston Medical Center
  • Perry, GA FULL_TIME
  • Central Sterile Process (PH) Full Time · 8:00a - 4:30p · Call typically not required H06 Position Summary: Assists in ensuring an effectively organized and operational unit through appropriate cleanin...
  • 1 Month Ago
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C
Sterile processing technician
  • Concentric Healthcare Staffing
  • Macon, GA FULL_TIME
  • Concentric is currently seeking candidates in Surgical profession with focus in Technician (Sterile Processing) for a 13 week contract in the Macon, GA area. Concentric is a premier staffing firm dedi...
  • 1 Month Ago
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0 Claims Processing Clerk, Sr. jobs found in Macon, GA area

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LIFE INSURANCE SALES AGENT REMOTE
  • The Janet Brennan Agency
  • Macon, GA
  • Why work with us? Have your Life & Health Insurance license? Are you willing to put in the study for a week to pass the ...
  • 4/19/2024 12:00:00 AM
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T
Remote Sales Agent
  • The Busick Agency
  • Macon, GA
  • The Busick Agency, an agency of Symmetry Financial Group, is looking for remote sales representatives to become a part o...
  • 4/19/2024 12:00:00 AM
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Claims Adjuster Trainee
  • Progressive Corp.
  • Macon, GA
  • Claims Adjuster Trainee **Job Number** : 188812 Join one of FORTUNEs 100 Best Companies to Work For! As a **claims adjus...
  • 4/19/2024 12:00:00 AM
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Insurance Sales Representative - Entry Level Sales
  • PRT Financial
  • Warner Robins, GA
  • ABOUT THE INSURANCE SALES REPRESENTATIVE POSITION: We are looking for a qualified life insurance sales representative to...
  • 4/19/2024 12:00:00 AM
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Experienced Claims Adjuster
  • Progressive Corp.
  • Macon, GA
  • Experienced Claims Adjuster **Job Number** : 189722 Join one of FORTUNEs 100 Best Companies to Work For! Develop your cl...
  • 4/18/2024 12:00:00 AM
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M
Independent Insurance Claims Adjuster in Macon, Georgia
  • MileHigh Adjusters Houston Inc
  • Macon, GA
  • Exciting Opportunity for Aspiring Claims Adjusters! INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to ...
  • 4/17/2024 12:00:00 AM
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Remote - Insurance Broker
  • Thompson Agency
  • Macon, GA
  • MUST HAVE: Ready to start IMMEDIATELY WINNERS Mindset Self-Motivated HUNGRY TO WIN Goal Oriented Believer in Self-Discip...
  • 4/15/2024 12:00:00 AM
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Claims Adjuster - Auto Damage
  • Progressive Corp.
  • Macon, GA
  • Job Description - Claims Adjuster - Auto Damage (186830) **** Claims Adjuster - Auto Damage **Job Number** : 186830 As a...
  • 4/15/2024 12:00:00 AM
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About Macon, Georgia

Macon (/ˈmeɪkən/), officially Macon–Bibb County, is a consolidated city-county located in the state of Georgia, United States. Macon lies near the geographic center of the state, approximately 85 miles (137 km) south of Atlanta, hence the city's nickname "The Heart of Georgia." Located near the fall line of the Ocmulgee River, Macon is the county seat of Bibb County and had a 2017 estimated population of 152,663. Macon is the principal city of the Macon metropolitan area, which had an estimated population of 228,914 in 2017. Macon is also the largest city in the Macon–Warner Robins Combined St...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Processing Clerk, Sr. jobs
$43,179 to $53,257
Macon, Georgia area prices
were up 1.5% from a year ago
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