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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates strong customer service skills by efficiently managing claims-related inquiries and ensuring accurate documentation in claims systems. Proficient in communication and organization, with the ability to handle multiple priorities and work collaboratively in a team environment.
Highest-signal resume keywords
Customer Service ExperienceClaims ProcessingData EntryCommunication SkillsOrganizational Skills
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 CodingData EntryPC LiteracyMicrosoft OfficeKeyboarding
Soft Skills
Interpersonal SkillsTeamworkStress ManagementMulti-Priority HandlingDeadline Management
Certifications & Qualifications
Professional Certification
Industry Keywords
Claims ManagementCustomer ExperienceJurisdiction IssuesIndependent Medical ExaminationsQuality Programs
About the role
Key responsibilities & impact- Provide high quality service to internal and external customers, delivering an easy and efficient customer experience for routine lost time
- Process incoming calls, faxes and voicemails from claimants, providers, clients, attorneys, etc., resolving claims-related questions and issues according to guidelines and policies
- Communicate claims status and current claim activity with clients and appropriate medical contacts
- Respond to inquiries about jurisdiction- and claim-specific issues
- Enter data into claims systems and ensure claim files are properly documented and claims coding is correct
- Coordinate claimant address updates or changes with internal departments
- Provide referrals to legal, utilization review, pharmacy, and Special Investigations Unit (SIU) as appropriate
- Coordinate independent medical examinations
- Support the organization's quality programs
- Perform other duties as assigned
Requirements
What you’ll need- High school diploma or GED required
- Associate’s degree from an accredited college or university preferred
- Professional certification as applicable to line of business preferred
- Two (2) years of administrative and/or customer service experience or equivalent combination of education and experience required
- Excellent oral and written communication skills
- PC literate, including Microsoft Office products
- Strong investigation and organizational skills
- Good interpersonal skills
- Ability to work in a team environment
- Ability to meet or exceed Performance Competencies
- Ability to handle work-related stress
- Ability to handle multiple priorities simultaneously
- Ability to meet deadlines
- Computer keyboarding
- Travel as required
Benefits
Comp & perks- Work-life balance
- Caring culture
- Equal Opportunity Employer
- Drug-Free Workplace