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Managed Care Claim Assistant I
About the position
AmTrust Financial Services, a fast-growing commercial insurance company, has an opportunity for a Claim Assistant I within our Managed Care organization where your talent and abilities contribute to our competitive edge. The Managed Care Claims Assistant will perform a variety of support services to our Worker’s Compensation Managed Care department as described below, with oversight from Clerical Supervisor. The Managed Care Claims Assistant I maintains a solid understanding of AmTrust’s mission, vision, and values. Upholds the standards of the AmTrust and Claims organization. This role can be hybrid out of any AmTrust office
Responsibilities
- Processes treatment requests, referrals, and other activities as needed for Managed Care department following established methods to ensure compliance and privacy.
- Reviewing records with high attention to detail regarding documentation and accuracy to determine eligibility of requests.
- Generates letters from system templates, arranges distribution of response letters following proper handling procedures.
- Coordinates with adjusters, nurses, and others as needed to obtain claims or clinical information necessary for processing or assignment.
- Prioritizes requests and referrals based on review type, urgency of need while ensuring jurisdictional timeframes and department turnaround times are met.
- Meets or exceeds industry standards of daily productivity while maintaining accuracy.
- Accurately documents within multiple systems to reflect actions taken in response to referrals and requests.
- Performs general maintenance of claims documents across various systems.
- Adheres to any compliance changes as directed by supervisor.
- Other administrative tasks as assigned.
Requirements
- High school diploma
- Some college preferred
- 2+ years of experience in a worker's compensation case management department or related experience
Benefits
- Medical & Dental Plans
- Life Insurance, including eligible spouses & children
- Health Care Flexible Spending
- Dependent Care
- 401k Savings Plans
- Paid Time Off
