Claims Assistant I

We're thrilled that you are interested in joining us here at the Amynta Group The Claims Assistant is under moderate supervision, utilizes general understanding of department's operations and objectives to provide administrative support related to medical authorizations, indexing incoming mail, claims payments, bill inquiries, coordination assistance, and customer service to the claims department. This position will answer general claims payment questions from customers and will act as a liaison for technical staff and internal/external customers in responding to routine inquiries.

They are also responsible for timely claim filing of state required forms. Review incoming new losses to determine claim set up. Essential Functions:

Index and triage incoming medical reports, requests for authorizations and other departmental electronic within the same day as receipt. Contact accounts on First Notices of Loss to obtain missing information pertinent to file set-up. Under adjuster direction, complete the medical authorization process for physical therapy, chiropractic and acupuncture treatment.

Provide customer service - answer telephones and re-direct callers as necessary to properly respond to customer inquiries. Assist in the administration of claims by making follow up status calls to providers. Perform data entry to work diaries and create activity notes.

Complete and prepare documentation for reporting to the NYS WC Board. Update claimant information upon receipt of approved changes. Complete assigned work via diaries and work queues in a timely manner.

Respond to all requests and inquiries from claims staff, vendors, and others as appropriate. Reviews and verifies information which may include source documents, policies, claims files, summons & complaints, salary data, etc. Ensures completion and accuracy of data, paperwork, and/or forms with NYS.

Acts as a technical resource for internal and external customers/contacts by providing answers to routine inquiries and coordinating responses; resolving problems and/or discrepancies which may involve research and data collection. Process payments, answer phone calls, authorize treatment associated with Medical Only claims. Post entries in the claim system, create suspension report and update activities in a timely manner.

Maintain a working knowledge of New York State requirements and WC Law. Perform other duties as requested by manager. Qualifications: To be successful as a member of our exceptional Claims Team:

Candidates should have good oral and telephone communication skills as well as excellent typing skills. Licensing required within one year. Strong written and verbal communication skills, attention to detail and deadline structures.

The ability to work within a fast-paced environment is essential. Working knowledge of Microsoft Office products - Intermediate Excel, Word and PowerPoint skills. Working knowledge of claims related systems beneficial.

Strong verbal, written communication skills and customer service skills gained through previous work experience. Knowledge of Medical Terminology preferred. Ability to work both independently and collaboratively with all levels of staff. 4-year degree required or knowledge of workers' compensation principles and policies equivalent preferred.

The Amynta Group (the " Company ") is committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee on the basis of any ground of discrimination protected by applicable human rights legislation. The information collected is solely used to determine suitability for employment, verify identity and maintain employment statistics on applicants. Applicants with disabilities may be entitled to reasonable accommodation throughout the recruitment process in accordance with applicable human rights and accessibility legislation.

A reasonable accommodation is an adjustment to processes, procedures, methods of conveying information and/or the physical environment, which may include the provision of additional support, in order to remove barriers a candidate may face during recruitment such that each candidate has an equal employment opportunity. The Company will accommodate a candidate to the point of undue hardship. Please inform the Company's personnel representative if you require any accommodation in the application process.