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)
The Claims Consultant will handle and analyze primary General Liability, Excess GL and Excess Commercial Auto claims and/or Attorney Professional Liability Claims from inception to conclusion, reviewing claims to determine nature of loss, coverage provided, and scope of claim, make recommendations regarding settlement/disposition of claims and negotiate to conclusion. This position involves litigated and non-litigated matters. The position also ensures ongoing adjudication of claims within the Company standards, industry best practices and specific client service requirements.
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The location of this position is flexible.
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