Description

JOB SUMMARY

Provides claims support, data organization and administrative service to Insurance and Claims Department. Maintains and updates claims files and Vane’s Insurance & Claim System (VICS). Reports directly to and takes direction from the Senior Claims Specialist.

ESSENTIAL DUTIES & RESPONSIBILITIES

Administrative Support

• Enter data from medical invoices into claims.
• Receive, review, file, and/or email various reports and notifications.
• Create, scan, copy, file, and/or distribute various documents.
• Draft various documents and correspondence.
• Support Insurance and Claims Department in litigation and claims management.
• Any other administrative duties as assigned.

Claims Processing

• Create and organize claim files.
• Maintain and update claim files in VICS.
• Assist with claims processing of vessel related damage, oil spill, and injury/illness claims.
• Assist with claims processing of land-based employee workers’ compensation, automobile, third party, and other claims.
• Submit medical claims/invoices for audit with outside vendor, reduce audited claims, complete letter to provider serving as EOB, and submit to accounting.
• Assist with data compilation and preparations for submitting claims for insurance reimbursement.
• Assist with processing of ‘maintenance and cure’ payments, wages, along with other financial documentation.
• Administer VICS with Insurance and Claims team to capture data needed for enhancements and additional reporting.

Insurance

• Gain knowledge of Certificates of Insurance and various other insurance documents and certificates.
• Complete applications for various insurance documents and certificates.
• Gain knowledge of and utilize various company and industry-specific electronic and/or online resources.

Other duties

• Participate in insurance and claims-related meetings.
• Interact with vessel crew members within the context of claims.
• Interact with managers within the context of insurance and claims.
• Interact with contractors and vendors within the context of insurance and claims.

Qualifications

QUALIFICATION REQUIREMENTS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION AND/OR EXPERIENCE

• Four to six years related experience
  • Military experience is a plus
  • Jones Act/General Maritime knowledge/experience is a plus
  • Insurance industry knowledge/experience is a plus
  • Case management experience is a plus
• Associates / Bachelor’s Degree, preferred
• Licensed Practical Nurse / Registered Nurse, preferred

KNOWLEDGE, SKILLS, AND ABILITIES

• Meticulous attention to detail
• Ability to manage multiple priorities, be a self-starter, clearly communicate in a team environment and with providers and vendors.
• Desire to take on increasing responsibilities.
• Willingness to be available off hours.
• Excellent verbal and written communication skills.
• Customer service friendly.
• Strong computer experience, especially in Word, Excel and with email.
• Experience managing and navigating various websites/database content.
• Knowledge of worker’s compensation, medical terminology, and insurance preferred.

PHYSICAL DEMANDS

Light - Lifting 20 pounds maximum with frequent lifting and/or carrying objects weighing up to 10 pounds. Walking or standing to a significant degree, involves sitting most of the time with a degree of pushing and pulling.

WORK ENVIRONMENT

Limited - General office environment infrequently exposed to extreme atmospheric conditions (temperature, noise, fumes, dust, etc.)