State: FL City: Tampa Area of Interest: Claims - TPA Exempt or Non-Exempt: Non-Exempt Job Description:
In this role, provide support to the local claims office. Responsibilities include a variety of administrative tasks as well as coordination of the local EDI efforts.
• Review EDI rejections list from state every Tuesday and Thursday and determine reason for rejection and facilitate appropriate corrected action needed to allow timely transmission to the state
• Work with home office EDI team to assist in clearing any rejection that requires home office or systems assistance in resolving
• Complete heat ticks as needed to clear rejections
• Distribute EDI rejection list to team by 12:00 every Friday and Tuesday to allow ample time for coding errors to be corrected
• Audit first report filing daily and provide feedback to adjuster and supervisor on any
corrections that are needed
• Distribute 20 day bill aging report to team every Monday to allow for review and processing of aged bills in order to facilitate timely bill payment and reduce penalties
• Review work bench monthly and publish results to PMA Claims Management team.
• Review indemnity penalties and work with state in mitigating the penalties. i.e. correctly coding the file
• Assure any indemnity penalties are correctly charged to PMA
• Determine from bill review team the drivers behind the bills being paid late and communicate same to PMA management and service team in an effort to facilitate corrective action that will reduce future penalties
• Complete and submit annual state form
• Work with state, client and claims adjuster to resolve any issues raised by the state
• Provide supervisor or service manager with diary dates of the filing to assure adequate oversight as late filing penalties can be significant
• Assist supervisor and team in presenting EDI training to team annually, directed at
reducing the number of EDI rejections and increase adjuster understanding of EDI and correct file coding
• Assist team in obtaining clarification from home office EDI team on any EDI coding questions that cannot be answered locally
• D emonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.
Requirements:
Requirements:
• Strong administrative skills typically exemplified by two or more years of related experience
• Prior experience in an insurance environment, program in General Insurance (INS) a plus
• Demonstrated computer skills to include proficiency in word processing, spreadsheet, and knowledge of database applications a plus
• Ability to handle multiple tasks and prioritize workload accordingly
• Good interpersonal skills and ability to effectively communicate
• Ability to travel for business purposes, approximately less than 10%