Medical Claims Specialist Trainee

Other jobs >> General




Location(s)Birmingham AL


Are you ready to put your telephone skills to use? Do you have experience in the medical field? Are you ready to change to a back-office environment with limited face to face interaction with customers? If this sounds like the career you are seeking, our Medical Claims Trainee is the opportunity for you! We pay for your training!!!

Our specialists are responsible for the investigation, valuation, establishment of exposure, negotiation and settlement of assigned No-fault and Med pay claims within a stipulated monetary authority. Ensures that all assigned claims are concluded promptly, equitably and economically within the provisions of the policy contract and in accordance with the damages presented. Since this is an entry level position, the incumbent works with minimal authority under the direct supervision of a Unit Manager and the Manager of Training.

Position Responsibilities:

- Attends and successfully completes Basic Claims School and any other programs of study selected for the employees training.

- Participates in and completes specific Pictorial Courses and other selected self-study courses during a defined period of time. Before being eligible for promotion within the PIP area the following Pictorials must be completed with a passing score: Medical Tests and Signs, Interpreting Medical Reports, Personal Auto Coverage, Property Casualty Basics, Claims Investigation, Claims Statements and Legal Concepts and Doctrines.

- The PIP Specialist Trainee must maintain a passing average in all formal courses that have been developed for the individual. Formal Performance Evaluations must result in a Meets Expectation or higher rating. An acceptable level of competencies pertaining to the position must be maintained.

- Must begin to prepare for any State Licensing exams required to fulfill licensing requirements in the states to be handled.

- For a period of two to four weeks, the PIP Specialist Trainee may work in Loss Reporting or Subrogation. Here the employee learns the basic functions of the Claim System, takes loss reports, secures recorded statements and will interact with Insureds, Claimants and others in the initial stage of a claim as well as handling assigned subrogation claims for recovery.

- Reviews loss for purposes of coverage verification and to determine exposures. Recommends and enters potential exposures into the system for approval within 72 hours of receipt.

- If coverage cannot be verified, refers to manager for further instructions and completes coverage investigation as directed.

Position Qualifications:

- Candidates must have a high school degree witha1 year full time work experience after graduation. A4 year college degree is preferred.

- Must have good computer skills.

- Must have good planning and organizing skills.

- Must have excellent written and verbal communication skills. Some positions may require specific bilingual skills.

- Must have the ability to deal with conflict.

  • 1
  • Negotiable
  • None
  • None
  • Re-97496
  • Permanent
  • 3

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