Claims Assistant

• Provide clerical, administrative, and data-entry support for workers’ compensation claims administration
• Support Claims Examiners with claim setup, payment processing, correspondence, regulatory filings, and records maintenance
• Communicate with claimants, medical providers, employers, investigators, attorneys, management, and TRISTAR staff
• Enter new claim information and establish claim files in the claims management system
• Assist with telephone communications concerning light-duty claims as directed
• Support scheduled payment processing under Claims Examiner direction
• Process special mailing requests according to instructions and deadlines
• Prepare PLN notices and other state filings using information provided or approved by Claims Examiners
• Assist with mail processing and check printing
• Enter payments as directed by authorized claims staff
• Receive, organize, and distribute incoming mail; prepare outgoing correspondence and claim-related documents
• Copy, scan, and organize documents
• Answer and route telephone calls, record messages, and direct inquiries
• Prepare, generate, and run claims management system reports
• Maintain accurate records and report missing information or processing discrepancies
• Perform other duties as assigned

Claims Assistant – Workers' Compensation

• Provide support to claims staff and perform office tasks depending on the client program
• Input and review notes and diaries in the claims management system
• Answer and initiate telephone calls, set up medical appointments, and provide customer service as required
• Prepare and distribute computer reports
• Set up, assign, reassign, and reopen claims within the claims management system
• Maintain claim data, including policy, coverage, date of loss, date of birth, and account information
• Process letters and other claim-related correspondence
• Upload and manage claim documentation, including legal files, policy documents, and medical records requests
• Process settlement payments, expense invoices, returned checks, and vendor setup requests
• Respond to general emails, phone calls, auditor requests, and stakeholder inquiries
• Generate loss runs and other claims-related reports
• Perform administrative duties including mail processing, filing, scanning, faxing, and report distribution
• Support special projects and perform other assigned duties

• Support claims staff in the setup and administration of workers’ compensation claims/case management
• Set up new claims
• Process mail and handle files until paperless
• Input notes/diary entries in the claims system
• Process payments as needed
• Process form letters, state forms, and reports
• Assist claims examiners with provider, claimant, and customer telephone calls
• Perform additional duties as assigned

• Answer phones, route calls, and take messages
• Prepare and mail overnight, regular, and certified correspondence
• Use ImageRight, WINS, and Microsoft Outlook, Word, and Excel
• Process and review invoices
• Open, prepare, sort, and scan mail into ImageRight
• Set up FNOL claims and related workflows, including coverage confirmation, incident/claim setup, ISO claim entry, lawsuit setup, broker acknowledgements, and examiner task assignment
• Submit HIPAA authorizations through the MCS portal and import received medical records into ImageRight
• Process Summons & Complaints
• Redact policies in ImageRight
• Share GNY files with third parties via OneDrive
• Set up Independent Medical Exams
• Back up the main switchboard as needed
• Participate in special projects and perform additional duties as required

• Set up and enter new claims into the claims management system
• Input and review notes and diaries in the claims management system as instructed
• Process payments
• Process mail and handle filing, faxing, and photocopying
• Review, prepare, create, and/or send letters, reports, and forms
• Answer and initiate telephone calls
• Set up medical appointments
• Provide customer service as required
• Complete assigned activities and projects, including preparing and distributing computer reports
• Perform other assigned duties
• Support the organization's quality programs

Claims Assistant – Workers Compensation

• Provide administrative support to assigned Claims Examiners
• Contact insureds and other relevant parties to obtain information needed to process insurance claims
• Document conversations and information in the enterprise resource planning (ERP) system
• Update claims information and access, search, and retrieve data
• Stay current with diary tasks and procedural changes
• Provide exceptional customer service to internal and external customers
• Provide information to insureds, claimants, and outside vendors as requested by the Examiner
• Process claims for indemnity payments and state-mandated forms
• Process claims-related payments
• Assist Claims Examiners through claim resolution on related administrative projects
• Support Claims Examiners in preparing, processing, and monitoring payments
• Communicate pertinent claim information to clients, legal counsel, service providers, and internal claims staff
• Ensure claims documentation is accurate and complete for auditing purposes