Insurance Claims Coordinator is responsible for coordinating and supporting initiatives relative to the evaluation, processing, and handling of insurance claims for an organization. Acts as a liaison between the organization, its insurance provider and agents, claimants, and policy holders regarding the status and eligibility for coverage for all relevant claims. Being an Insurance Claims Coordinator reviews claims to make sure that billing requirements are met, updates accounts as necessary, answers inquiries, and makes recommendations for resolution. Typically requires an associate degree or its equivalent. Additionally, Insurance Claims Coordinator typically reports to a manager. The Insurance Claims Coordinator gains or has attained full proficiency in a specific area of discipline. Works under moderate supervision. To be an Insurance Claims Coordinator typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)
The above represents the salary range for this job requisition. Ultimately, in determining your pay, we'll consider your location, education, experience, and other job-related factors. Your recruiter can share more information about the specific salary range during the hiring process.
This position may either work remote in our listed states or a hybrid schedule in the Charleston, West Virginia office. The position will report to the Director, Claims Systems and Analytics.
JOB OBJECTIVE:
The Technical Coordinator, Claims Systems and Analytics develops and performs statistical analyses using company data for the purpose of measuring claims outcomes. Utilizes industry standard reporting tools to establish claims dashboards and tools for the purpose of determining strategy and focus. Develops and implements predictive modeling tools and resources to assist the claims disciplines in early identification of red flags and strategy recommendations. Develops and assists in the implementation of new business requirements for new products, systems, and jurisdictions. This position serves as the administrator of the claims quality review system; and provides quarterly and annual analytics for the purposes of identifying areas that need improvement on the individual and team level. Ensures our products and systems are in regulatory compliance, efficient for the end user, and produces accurate calculations. This position utilizes expert knowledge of regulatory and jurisdictional requirements combined with innovative thinking to build systemic processes and effective claims management tools. This position analyzes quantitative and qualitative business indicators, makes recommendations for continuous improvement, and makes technical decisions in accordance with delegated authority.
ESSENTIAL FUNCTIONS:
OTHER FUNCTIONS:
KNOWLEDGE, SKILLS AND ABILITIES:
This position has been evaluated in accordance with the Americans with Disabilities Act. Encova Insurance makes every effort to reasonably accommodate disabilities to permit performance of the essential functions and candidates who need such accommodation are encouraged to seek it. This description reflects the nature and level of work performed by associates in this position. It is not an all-inclusive inventory of duties, responsibilities and qualifications required. It provides an accurate overview of the work and skills needed to perform this position. Because job content may change from time to time, Encova Insurance reserves the right to add and/or delete functions from this job as it deems necessary for business reasons.
Ready to join our team?
At Encova Insurance, we firmly believe that our associates drive our company's success by delivering unrivaled service to our customers. With success in mind, we make an ongoing effort to provide an environment that offers challenging, stimulating and financially rewarding opportunities.
Join us to discover a work experience where your diverse ideas will be met with enthusiasm - where you can learn and grow to your fullest potential.
What you can expect from us
Join our family of industry leaders, and let us reward you with a competitive salary, bonus and benefits package that includes but is not limited to: a 401(k), wellness programs, bonus incentive plans and flexible schedules, with an early close of the office every Friday. Additionally, Encova aspires to be an outstanding corporate citizen in all the markets we serve; we encourage and support associate participation in community initiatives through our foundations.
Encova Insurance is an EOE/E-Verify employer.
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