Claims Assistant - Houston, United States - TRISTAR RISK MANAGEMENT

Description

This position will be a hybrid position. Training will be in the office at our Houston, TX branch. Thereafter the employee only have to come into the office occasionally.

Must live in Houston, TX or close enough to make the commute to the office.
***:Under close supervision performs clerical and data entry tasks that assist in administration of workers' compensation claims. This position requires considerable interaction with claimants on the phone, and with management, other Claims Examiners, and other TRISTAR staff in the office; therefore consistently being at work in the office, in a timely manner, is inherently required of this position.


DUTIES AND RESPONSIBILITIES:

• Sets up new claims in system and paper files, ensuring all documentation is present and correct.
• Prepares, schedules, and processes benefit and medical payments on claim files as directed by the Claims Examiner.
• Documents all work product and claim activity in the electronic claim file.
• Prepares and prints letters, benefit notices and labels.
• Provides clerical support, including filing, faxing, sorting, photocopying, and alphabetizing.
• Communicates pertinent claim information to the client, legal counsel, medical and rehab providers and internal claims staff.
• Answers phone calls, take messages and responds appropriately.
• Other duties as assigned.
• Essential job function.

EQUIPMENT OPERATED/USED:
Computer, telephone, 10-key, fax machine, printers and other basic office equipment.


QUALIFICATIONS REQUIRED:


Education/Experience:
High school diploma or GED, and one (1) year experience in the workers' compensation claims industry (preferred).


Knowledge, Skills and Abilities:

• Proficient keyboarding skills (type 45 wpm).
• Working knowledge of medical/legal terminology.
• Ability to alphabetize and collate.
• Proficient in Word.
• Ability to follow written and spoken instructions from several individuals.
• Ability to produce accurate and detailed work.
• Excellent verbal and written communication skills.
• Courteous telephone skills.
• Ability to effectively prioritize multiple projects and due dates.
• Ability to work independently, as well as in cooperation with workgroup.

Here are some the benefits you can enjoy in this role:

• Medical, Dental, Vision, Life Insurance and Disability
• 401(k) plan
• Paid time off
• Referral bonus
• Paid holidays.

MENTAL AND PHYSICAL REQUIREMENTS

1. MENTAL EFFORT
a


Reasoning development:
Follow one
- or two-step instructions; routine, repetitive task.

Carry out detail but uninvolved written or verbal instructions; deal with a few concrete

variables.

Follow written, verbal, or diagrammatic instructions; several concrete variables.

X Solve practical problems; variety of variables with limited standardization; interpret instructions.

Logical or scientific thinking to solve problems; several abstract and concrete variables.

Wide range of intellectual and practical problems; comprehend most obscure concepts.

b


Mathematical development:
Simple additional and subtraction; copying figures, counting, and recording.

Add, subtract, multiply, and divide whole numbers.

X Arithmetic calculations involving fractions, decimals, and percentages.

Arithmetic, algebraic, and geometric calculations.

Advanced mathematical and statistical techniques such as calculus, factor analysis, and probability determination.

c


Language development:
Ability to understand and follow verbal or demonstrated instructions; write identifying information; request supplies verbally or in writing.

Ability to file, post, and mail materials; copy data from one record to another; interview to obtain basic information such as age, occupation, and number of children; guide people and provide basic direction.

X Ability to transcribe dictation; make appointments and process mail; write form letters or routine correspondence; interpret written work instructions; interview job applicants.

Ability to compose original correspondence, follow technical manuals, and have increased contact with people.

Ability to report, write, or edit articles for publication; prepare deeds, contracts or leases, prepare and deliver lectures; interview, counsel, or advise people; evaluate technical data.

2. PHYSICAL EFFORT
a.

Physical activity required to perform the job:

Sedentary work:

Exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects.

Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.


X Light work:
a. Exerting up to 20 pounds of force occasionally

b. Exerting up to 10 pounds frequently

c. Exerting a negligible amount of force constantly to move objects

(If the use of arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and