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Surety HR

Claims Analyst

Entry-Level JobVerifiedNo experience needed

Career Insights for Claims Processor

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Based on Ohio data

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What they do

A Claims Processor reviews and processes insurance claims and determines whether an insurance policy will cover a claim. Gathers information from policy holders and organizes insurance files; may process checks with payments to policy holders when a claim is approved.

$41,554 / year median in Ohio

-8% projected decline

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Job Description

Position Summary:
Telephonically intake work-related injury information to prepare claim for electronic filing with the Ohio BWC. Process claim paperwork for new and existing work-related injuries. Continue to manage medical-only work-related injuries to identify any problems/issues after return to work and build relationships with employers.
Primary Duties & Responsibilities:
1. Review and verify information entered by the Intake Department 2. Initiate contact with injured workers and employers to obtain information regarding new claims for electronic filing with the Ohio BWC. 3. Follow up with injured workers and employers for treatment and return to work information. 4. Document all phone calls, emails and faxes sent to injured workers, employers and/or providers in computer system. 5. Assist Intake Department in contacting the provider for initial medical. 6. Accept and approve indexed medical documents. 7. Communicate with the Case Management Supervisor regarding claims that meet the case management referral criteria and make referrals accordingly. 8. Prepare new claims or updates to existing claims for electronic filing by accurately entering information in the computer system. 9. Respond to customer inquiries regarding claim issues. 10. Assist SMAI with maintaining a high level of customer satisfaction. 11. Incorporate staff development training and changes in SMAI policies and procedures into the claim analyst activities. 12. Other duties as assigned.
Knowledge, Skills & Abilities Required:
High School diploma or equivalent General knowledge of the insurance industry, with workers' compensation exposure preferred. Additional skills include, but are not limited to, effective written and verbal communication, accurate data entry, problem-solving skills, strong organizational ability and attention to detail. Basic computer literacy skills preferred
Job Type:
Full-time Pay:
$18.00 - $20.00 per hour
Benefits:
Dental insurance Health insurance Life insurance Vision insurance
Work Location:
Hybrid remote in Westlake, OH 44145