Claims Coordinator

Morgan White Group•Ridgeland, MS

4d•Onsite

About The Position

The Claims Coordinator reports to the Claims Department Manager in the MWG-Administrators Division. The position is a nonexempt, hourly role and is located at 500 Steed Road, Ridgeland, MS 39157. GENERAL JOB DUTIES AND RESPONSIBILITIES: The Claims Coordinator is responsible for researching, communicating, and auditing claims and service request tickets (SRTs) to ensure departmental procedures are accurately completed. The Claims Coordinator must be detail-oriented, professional, and effectively communicate results with management. Prior claim knowledge is required. The requirements listed here are representative of the knowledge, skills, and ability required. Audits internal processes to ensure policies and procedures are followed. Release adjudicated medical claims. Perform regular audits of processed claims to ensure quality standards. Identify trends in errors and report findings to the Claims manager. Completes reports on the findings from audit reviews. Identify and recommend solutions for better workflow processes within the department. Assist in training and processing special pend codes. Special projects assigned by the department manager or supervisor. Assists with updates to training material and other department resources. Perform other duties and responsibilities as assigned.

Requirements

High School Diploma or GED required; associate or bachelor's degree is preferred
Must have 1-2 years of previous insurance claims experience
Must be proficient in computer skills and have strong knowledge of Microsoft Outlook, Windows, Excel, and Word
Must be able to learn and be proficient with the software used in the TPA Department
Must possess time management, organizational, and problem solving
Must be able to work well under pressure with multiple priorities and meet deadlines
Must be able to multitask while maintaining attention to details
Must be able to read, write, and speak English; Spanish is a plus
Must have basic typing skills
Must be able to work as scheduled
Must possess sight and hearing senses or use prosthetics that will enable these senses to function adequately so that the requirements of the position as stated above can be fully met
Must be able to bend, stretch, reach, and sit or stand at a desk during 85% of the workday
Must be able to lift, stoop, and carry small equipment items and supplies, possibly weighing up to 20lbs

Nice To Haves

associate or bachelor's degree is preferred
Spanish is a plus

Responsibilities

Researching, communicating, and auditing claims and service request tickets (SRTs)
Audits internal processes to ensure policies and procedures are followed
Release adjudicated medical claims
Perform regular audits of processed claims to ensure quality standards
Identify trends in errors and report findings to the Claims manager
Completes reports on the findings from audit reviews
Identify and recommend solutions for better workflow processes within the department
Assist in training and processing special pend codes
Special projects assigned by the department manager or supervisor
Assists with updates to training material and other department resources
Perform other duties and responsibilities as assigned