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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in claims processing, including data entry, quality control, and effective communication with customers and vendors. Proficient in utilizing claim processing systems and P.C. software applications to manage workload and ensure timely claim assignments.
Highest-signal resume keywords
Claims ProcessingData EntryQuality ControlCustomer ServiceP.C. Software Applications
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims Processing FunctionsAutomated Processing SystemsAlphabetic and Numeric FilingBasic Math SkillsData Retrieval and Correction
Soft Skills
Ability to Work Under PressureOrganizational SkillsEffective CommunicationProblem SolvingMulti-tasking
Tools & Technologies
Claim Processing SystemPBX Console
Certifications & Qualifications
ACG Approved Training Program
Industry Keywords
Claims AssignmentSubrogationQuality Control TasksWorkload AssignmentsCustomer and Vendor Interaction
About the role
Key responsibilities & impact- Assign claims electronically according to established guidelines
- Recognize subrogation potential and refer claims appropriately
- Update claims files to document assignments
- Review assignments to ensure proper load-balancing
- Perform quality control tasks for timely claim assignment
- Monitor claim systems and intake reports for proper assignment
- Notify management of system problems or potential issues
- Forward claim files to appropriate areas, including Legal, as necessary
- Perform high-level support duties for proper claims handling
- Assist management with department projects and research
- Gather information for management reports
- Create and distribute reports and documents, including workload assignments, open claims, and attendance reports
- Enter, process, retrieve, and correct data in systems
- Review claim files to ensure payments are disbursed appropriately
- Assist staff with claim support functions, correspondence, memos, and telephone inquiries during peak periods or staff shortages
- Answer customer and vendor calls and provide information
- Perform other related duties as assigned
Requirements
What you’ll need- High school education or equivalent
- Completion of ACG approved training program for the position
- P.C. software applications
- Knowledge of general claim processing functions
- Knowledge of claim processing system
- Ability to work under pressure
- Ability to organize and prioritize work
- Ability to prepare claim files
- Ability to communicate effectively with others over the telephone and in person
- Ability to investigate policy coverage, including establishment of new policies and verification of cancelled policies
- Ability to compose a descriptive narrative
- Ability to perform alphabetic and numeric filing
- Basic math skills
- Ability to bend and stoop to file and/or retrieve claims documents
- Ability to sit for the majority of the day
- Ability to operate a PBX console
- Ability to handle multiple tasks
- Ability to use automated processing and computer systems
- Ability to audit records and computer files
- Ability to rotate within department to perform various training or support functions
- Ability to provide high quality customer service
- Ability to analyze and problem solve
- Valid driver's license required if primary responsibilities involve in-person inspections or frequent in-person meetings with members
- Willingness to work irregular hours, including various shifts and weekends
- Background and drug screen required for offered employment
- Regular and reliable attendance is essential
Benefits
Comp & perks- Medical plans with multiple coverage options, including HSA eligibility
- Prescription drug coverage
- Dental and vision benefits
- Employee Assistance Program
- Company-paid basic life insurance
- Optional supplemental life insurance and dependent coverage
- Short-term and long-term disability coverage
- Critical illness, accident, and pet insurance options
- 401(k) plan with company match and additional company contribution
- Health Savings Account (HSA) and Flexible Spending Accounts (FSA) options
- Paid Time Off (PTO)
- 10 company-paid holidays annually for full-time employees
- 1 mental health day, 2 floating holidays, and 1 volunteer day for full-time employees
- Paid parental, bereavement, jury duty, and military leave
- Tuition assistance up to $5,250 annually; 80% covered by ACG
- Professional certification support with 100% reimbursement for eligible programs
- Opportunities for career development and advancement
- Complimentary AAA membership with roadside assistance and travel discounts
- Adoption assistance program
