The Administrative Claims Specialist will be responsible for performing administrative and other duties as assigned. Responsibilities include but are not limited to the following:
Essential Functions and Responsibilities
Manual data entry of lawsuit information and medical claim bills in a paperless environment using dual monitors.
Research and indexing of legal related mail for claim updating and assignment
Keying of Claims checks including expenses, arbitration settlements, interest, etc.
Provider Service Unit Operator; utilizing customer service skills to provide information to medical providers regarding billing, and/or treatment requests.
Ability to use all available applications to answer questions, within our guidelines, prior to transferring calls.
Project Handling; Knowledge of Microsoft Excel, Word and Outlook. Perform research and compile data onto an excel spreadsheet for analysis.
Report generation and distribution.
Review of Medical Bills; Review accuracy in billing, pre-certification compliance in accordance with the Decision Point Review Plan, and application of proper bill adjudication.
Participate in proactive team efforts to achieve departmental and company goals.
Perform other duties as assigned to support the various units within the claims department.
Qualifications and Education
High school diploma or general education degree (GED) and related training (i.e. medical billing, medical terminology, data entry); or six months related experience; or equivalent combination of education and experience.
Ability to understand and carry out instructions furnished in written, oral, or diagram form.
Ability to deal with problems involving several concrete variables in standardized situations.
Basic personal computer skills including electronic mail, word processing, spreadsheet, graphics, etc.
Ability to handle multiple tasks simultaneously.
Ability to work independently and prioritize projects and activities to meet deadlines.
Consistently produces a quality work product with attention to detail.
Comply with all safety policies, practices and procedures.
Ability to work in a fast paced environment.
About the Company
The Plymouth Rock Company and its affiliated group of companies write and manage over $2 billion in personal and commercial auto and homeowner's insurance throughout the Northeast and mid-Atlantic, where we have built an unparalleled reputation for service. We continuously invest in technology, our employees thrive in our empowering environment, and our customers are among the most loyal in the industry. The Plymouth Rock group of companies employs more than 1,800 people and is headquartered in Boston, Massachusetts. Plymouth Rock Assurance Corporation holds an A.M. Best rating of "A-/Excellent".