Insurance Claims Specialist

JOB SUMMARY:

This position requires knowledge of clerical/ secretarial procedures. The individual has no supervisory responsibilities. Individual is responsible for assisting the Risk Manager in ordering, maintaining inventory and dispensing of safety supplies. Individual is responsible for processing all claims the Risk Management Division receives. Individual will be assigned other duties as needed by Risk Manager and/or department director.

II. EDUCATION & EXPERIENCE REQUIREMENTS:

High School Diploma or GED required.

One (1) year experience in Workers’ Compensation, Liability Claims or related work preferred.

Individual must be able to type 50 wpm, and have good filing skills.

Knowledge of intermediate legal and medical terminology.

Proficient in Microsoft Word, Excel, Publisher, Power Point, Internet, and E-mail.

III. EMPLOYMENT REQUIREMENTS:

Applicant will be subject to a complete background investigation. Incomplete, inaccurate and/or failure to report information will cause the applicant rejection from consideration.

Applicant must take and pass pre-employment screenings administered by the City of Mission doctor at the City’s expense.

Applicant must have a current valid class “C” driver’s license from the department of Public Safety with no more than two (2) moving traffic violations within the past two (2) years.

Applicant will be asked to sign a confidentiality agreement with regard to the sensitive nature of the information being handled.

IV. SKILL ABILITY REQUIREMENT:

Ability to use computer programs such as Window OS and Microsoft Office Suite.

Ability to follow procedures for keeping records.

Ability to compute, maintain and prepare complex records correctly, insuring confidentiality.

Ability to demonstrate good organizational skills.

Ability to use eyes, hands and fingers at the same time to enter figures in computer and forms or to operate and compute.

Ability to think logically to analyze written materials, organize facts and interpret a wide variety of subject matter.

Ability to communicate orally and in writing in the English and Spanish language.

Ability to follow set or routine procedures.

Ability to use basic arithmetic in computing data.

Ability to type memos and forms.

Ability to follow instructions orally or in written form and perform tasks with little or no supervision.

Ability to perform a wide variety of different types of tasks without the variety itself causing a loss of efficiency.

Ability to make decisions based on available data/criteria, laws and regulations, or city policy.

Ability to handle special projects of diverse nature as assigned.

Ability to read and interpret documents such as safety rules and city policy and procedures.

V. EQUIPMENT/MATERIALS: General office and safety equipment/materials to

include but not limited to the following:

Personal Computer, Printer, CD ROM, USB Drives, Keyboard, Mouse, City Vehicle

Faxed Machine, Software Programs, Digital Camera, Telephone, Pens, rulers, highlighters, Typewriter, Safety equipment, Measuring tape, Copy machine, Video Camera, Paper cutter

Binding machine, Postage meter, Stapler, Scissors, First Aid supplies, Pain medicine, Copy machine paper

Personnel Policy Manual, Safety Manual

VI. ESSENTIAL JOB FUNCTIONS:

Answer telephone with clear, courteous, and business voice, and directs the calls to the appropriate destination to expedite response.

Receive visitors, answer questions and inquiries to resolve issues at hand or direct to appropriate destination.

Analyze and interpret financial data from computer.

Type purchase orders in computer for printing by the Purchasing division.

Make all necessary travel arrangements for departmental staff.

Process accounts payable invoices and submit to Finance for processing.

Enter or post data into computer as directed.

Process every element of a Workers’ Compensation claim.

Update departments on Work Status Reports.

Process Liability and Property claims.

Request information from departments to process all claims.

Use proper forms for submitting claims and reporting incidents.

Order safety supplies and distribute among the different departments when needed.

Copy documents, utilizing office equipment, as directed.

Prepare letters and packages for processing utilizing postage meter machine for mailing.

Compose letters and other documents as requested and within the time frame.

Receive and sort incoming correspondence, mail and packages within the office.

Undertake assignments/projects assigned.

Sort and file letters and other documentation.

Order and maintain inventory of office and safety supplies.

Fax/Email information to Workers’ Compensation office, clinics/hospitals, city departments and vendors.

Maintain good communication with all City departments.

Perform all job functions with special attention placed on good public relations, safety, and proper office procedures in compliance with city policies.

Perform accident field investigations; interview, claimants, potential witnesses, physicians, city employees, and others necessary to document fact in order to make a proper report. Make recommendations as to disposition of small claims. Write and maintain reports detailing initial investigations.

Create safety newsletters and bulletins.

Review and comply with recommendations of the TML local representative.

Monitor compliance with federal and state regulations.

Coordinate and participate in Safety Meetings with the safety representatives of each department.

Process the TML Insurance bill.

The above duties describe the chief functions of the job and are not to be considered a detailed description of every duty of the job.

VII. NON-ESSENTIAL JOB FUNCTIONS:

Organize meeting room setups and making coffee when necessary.

Pay: $16.15 per hour

Benefits:

• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Work Location: In person