Claims Processing Specialist

Summary: Perform complex and responsible clerical duties in the home office relating to the processing of claims.

Essential Duties and Responsibilities include the following.  Other duties may be assigned.

• Enter claim information into the automated system. Input new claim set-ups, claim changes (reserve increase/decrease, suffixes, adjuster codes, etc.), and maintenance under strict deadlines. Process rush letters and express claims. Complete mandated forms.
• Input information for automated drafts to be paid daily. Print automated drafts, type and input manual drafts, proofread, and mail. Issue stop payments and voids as necessary. Retrieve copies of cancelled checks when requested.
• Process credit transmittals by receiving checks and inputting amounts into the automated system. Forward checks to Customer Service. 
• Process subrogation and salvage checks by inputting information into the computer.
• Take loss reports over the phone from agents and claimants. Assist the call center with requested information.
• Input tax ID numbers of body shops, medical facilities, attorneys, and businesses requiring 1099s. Update screens to reflect address changes and new ID numbers. Send out 1099s.
• Incoming mail is indexed into the correct claim file, and the task is sent to an adjuster.
• Coordinate and handle to completion low complexity claims such as glass or towing/labor.
• Support claims staff with acquiring data such as police reports, medical records, billings, etc.  
•  Assist in answering questions from agents, adjusters, insureds, and clerical staff.
•  Print claim file materials as needed. 
•  Send out requested forms and supplies to adjusters in outside offices.
•  Compile data and complete special projects as required

Authority: Perform duties according to standard policies and procedures with some latitude for independent judgment.

Education and/or Experience: High school graduate or equivalent. Minimum of five years of claim clerical experience preferred.  

Certificates, Licenses, and Registrations: Intro to Insurance, Intro to Claims. 

Required Knowledge and Skills: 

• Exceptional written and verbal communication skills are required. Must be able to interpret and apply information from departmental policies, procedures, and manuals. The ability to draft clear, concise reports and routine correspondence is essential. 
• Strong interpersonal skills and professional telephone etiquette are necessary, with the ability to communicate effectively both in person and over the phone.
• The ideal candidate must have detailed knowledge of claim policies and procedures related to the work performed. 
• Review a variety of documents, forms, reports, and online data systems to complete claim set-up. 
• Access and enter information accurately using CRT, under strict deadlines. 
• Interpret and apply normal departmental policies and procedures. 
• Batch checks for mailing. 
• Maintain acceptable attendance as defined in the company personnel policy. 
• Strong organizational skills.
• Must have the ability to calculate figures and amounts such as discounts, interest, commissions, percentages, and other basic mathematical concepts with accuracy and efficiency.

Special Relationships (relationships to other people, internal and external, cost control, etc.): Has direct contact with agents, insureds, claimants, attorneys, physicians, and other service organizations in the processing of claims. 

Physical Requirements: While performing the duties of this job, the employee is occasionally required to stand, walk, sit, use hands to finger, handle, or feel, and talk or hear.  The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

The noise level in the work environment is usually moderate. 

Nodak Insurance Company complies fully with all federal, state, and local employment laws and shall provide equal employment and advancement opportunities for all persons regardless of race, color, creed, religion, national origin, sex, sexual orientation, age, the presence of any mental or physical disability, status with regard to public assistance or marriage, or any other category protected by local, state or federal law.