SUMMARY:
Primarily responsible for supporting the management of the all files by analyzing, indexing, e-indexing, and assigning a sub document type to all documents received by Departments within the Enterprise. Also responsible for identifying key information on documents and inputting information into the keywords of the document and in the appropriate data fields in the claim system.
PRIMARY RESPONSIBILITIES:
- Analyzes incoming documents and assigns the appropriate document sub type to them
- Reviews each document and adds pertinent information to the document keywords and to appropriate data fields in the claim system
- Opens, sorts, prepares, bundles, scans, and validates/verifies physical and electronic mail for all departments daily.
- Determine appropriate criteria to accurately index an electronic image to initiate workflow to the proper department.
- Performs computer inquires through multiple systems for other departments and verifies member coverage.
- Processes incoming faxes and identifies, sorts, bundles, scans, and validates/verifies fax messages whether physical or electronic.
- Maintains scanning equipment in appropriate working order according to documented guidelines.
- Maintains records according to the corporate retention guidelines.
- Maintains a basic understanding of other department processes and systems to enable accurate interpretation of documents.
- Performs data entry updates to tracking log for all returned Claims issued checks.
- Re-indexes and appropriately routes documents that have been assigned an improper document type or have been attached to an incorrect claim
- Sets priority activities to claim handlers as appropriate upon receipt and review of documents
- Performs other duties and special projects as requested.
- Assists with the creation of procedural documentation and workflows.
This description identifies the responsibilities typically associated with the performance of the job. The percentage of time in any responsibility may vary between positions. Other relevant essential functions may be required.
EMPLOYMENT QUALIFICATIONS:
- EDUCATION REQUIRED:
High school diploma or G.E.D required with additional training or college-level course work in business or insurance. Combinations of education and experience may be considered in lieu of additional training or coursework.
EXPERIENCE REQUIRED:
Minimum two years general office experience that includes previous relevant experience reviewing and providing specific document types to scanned images.
- SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:
- Excellent verbal and written communication skills.
- Excellent customer service skills.
- Basic knowledge of computers and spreadsheet software.
- Basic knowledge of word processing software.
- Ability to proofread correspondence for accuracy of spelling, grammar, punctuation, and format.
- Ability to work effectively with various business units.
- Ability to be an independent thinker to solve issues.
- Ability to manage multiple priorities and meet established deadlines.
- Excellent organizational skills and ability to prioritize work.
- Ability to verify data for accuracy.
- Knowledge of medical terminology.
- Knowledge of legal terminology.
- Ability to train and coach others to perform the core responsibilities.
- Ability to assist with the creation of procedural documentation and workflows.
Knowledge of multi-functional telephone system.
Ability to multi-task i.e. interacts on telephone while entering data
- ADDITIONAL EDUCATION, EXPERIENCE, SKILLS, KNOWLEDGE AND/OR ABILITIES PREFERRED:
- Previous experience in the workers’ compensation field.
- Previous experience with medical records, medical terminology and administrative support.
- Experience working with scanned images/document management system.
- Experience with state/legal documents.
- Insurance Institute of America (IIA) Certification Experience in Workers’ Compensation Claims Processing.
WORKING CONDITIONS:
Work is performed in an office setting with no unusual hazards.
Skills Required
- High school diploma or GED (college coursework in business or insurance or equivalent combinations accepted)
- Minimum two years general office experience including reviewing and assigning document types to scanned images
- Excellent verbal and written communication skills
- Excellent customer service skills
- Basic knowledge of computers, spreadsheet software, and word processing software
- Ability to proofread for spelling, grammar, punctuation, and format accuracy
- Ability to work effectively with various business units and manage multiple priorities
- Ability to verify data for accuracy and perform data entry into tracking logs and claim system
- Knowledge of medical terminology
- Knowledge of legal terminology
- Ability to train and coach others and assist with creation of procedural documentation and workflows
- Experience with scanned images and document management systems
- Previous experience in the workers' compensation field
- Previous experience with medical records and state/legal documents
- Insurance Institute of America (IIA) Certification or experience in Workers' Compensation Claims Processing
- Familiarity with multi-functional telephone systems and ability to multi-task while on the phone
What We Do
Emergent Holdings’ elite team makes lives, companies and communities better! Emergent Holdings is driven by a singular goal — improving the health and safety of our customers and our communities. How do we do that? We create innovative insurance products, technology solutions and services to support our key stakeholders — individuals, employers, providers and strategic partners — improving the health and safety of the people and places we serve. At Emergent Holdings, we’re inspired to create, to challenge the status quo, to think not just about what our customers need now, but what they will need in the future. We are strategic thinkers. We are industry innovators. We are market trendsetters. Together, we are Emergent Holdings. Our diverse team of established industry experts embraces a culture of innovation and entrepreneurial spirit. That means we’re focused on innovation, on leading and shaping our markets and improving health and safety for our customers and communities. For our customers, the result is a suite of solutions, services and products delivered ahead of market needs — and in anticipation of member demands. We are tireless in our pursuit of the exceptional, and our companies deliver optimal customer experiences and improve people’s lives every day, by making workplaces safer and delivering affordable, solutions-focused healthcare services.








