Claims Representative – Remote:

Delivers straightforward administrative and/or other basic business services in Claims. Examines and processes paper claims and/or electronic claims. Determines whether to return, pend, deny or pay claims within policies. Determines steps necessary for adjudication. Settles claims with claimants in accordance with policy provisions.

Compares claim application and/or provider statement with policy file and other records to evaluate completeness and validity of claim. Interacts with agents and claimants by mail or phone to correct claim form errors or omissions and to investigate questionable entries. Issues tend to be routine in nature. Good knowledge and understanding of Claims and business/operating processes and procedures. Works to clearly defined procedures under close supervision.

Responsibilities:

-Review claim submissions to confirm required documents have been received, verify medical codes, eligibility, other insurance, authorizations, and account benefit plans.

-Follows established policies and procedures to pay, pend for additional information, or deny claims.

-Adapt to and positively influence change by accepting feedback with a growth mindset to continuously improve.

-Follow processes and work independently to meet or exceed Key Performance Indicators (KPI)

-Ability to effectively excel in a virtual work environment through active participation in team huddles, Supervisor 1×1 or check-ins, using a variety of virtual tools, i.e. Outlook email, Skype for Business, Cisco Web-Ex or other similar applications.

-Maintains a high level of accuracy in all duties performed.

Legal Admin Assistant:

The Legal Department Clerk/Administrative Assistant reports directly to the Senior Paralegal and is responsible for performing a variety of tasks in support of attorneys and paralegals in SSB’s Legal Department.

Duties:

• Manage invoice payment process, including coding invoices.
• Utilize electronic invoice management system
• Maintain invoice tracking spreadsheet in Excel
• Manage Invoice E-Filing
• Interact with vendors and corporate accounting department to manage A/P issues as needed
• Set up new vendors in Profisee
• Manage Invoice payment status matters in OnBase and OHM
• Manage paper invoices as needed
• Manage wire payments as needed
• Add account numbers to OnBase as needed
• Manage quarterly chargebacks to licensee