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Job Description
1.
Summary :
Under the supervision of the Claims Supervisor, the Claims Intake Representative I will act as an in-house liaison for New Jersey Schools Insurance Group and the designated managed care company. The Claims Intake Representative I will perform all coordination and triage functions to find doctors within the managed care network. The Claims Intake Representative I will direct the injured employees to the appropriate doctors within the managed care network. The Claims Intake Representative I will also provide administrative functions for the Claims Department, generating claims set-up, completing the report questionnaires, and addressing intake claims inquiries. This position will also provide secretarial support across all departments, as requested. 1.
Functions :
a. Responsible for promptly answering all calls related to intake and triage functions including employee, employer, incident, injury, medical, and witness information. b. Facilitates and verifies information of the injured employees. c. Accurately completes the intake questionnaire and medical screenings. d. Appropriately directs injured employees to the appropriate medical facility. e. Ensures all necessary information is collected, reviewed and entered from the injured employee according to NJSIG's claims handling guidelines. f. Schedules medical appointments and ensure service level phone percentage is maintained as determined by the Claims Manager. g. Critically evaluates the intake information to ensure the injured worker is appropriately matched to the correct medical specialist in the proper geographic location. h. Works collaboratively with team members and NJSIG's workers' compensation managed care services provider to ensure the injured employee's needs are appropriately met. i. Assists in data collecting, monitoring, evaluating and analyzing workers' compensation trends for the purpose of developing and implementing protocols, policies, and procedures. j. Collaborates with NJSIG's in-house nurse case manager, as needed. k. Collaborates with their supervisor on the initial intake process, as needed. l. Assists with clerical tasks and provides secretarial support across all departments, as requested. m. Assists with greeting and welcoming guests, answering phone calls, and facilitating the prompt and accurate dissemination of messages and phone calls to NJSIG staff. n. Assists with receiving letters, packages, e.g., and alerting mailroom of deliveries. o. Monitors office and facility supplies and reorders same as needed, within budget; assists in making other office purchases, as requested. p. Exhibits excellent member services skills, including telephone and personal contact with members, workers' compensation claimants, and other callers. 2.
Qualifications :
a. High school diploma, General Educational Development certificate or state authorized high school equivalent certificate required, Associate's Degree in Business Administration, Finance or Accounting preferred; b. Minimum of one year of experience in a clerical support position required, experience in a secretarial capacity preferred; c. Knowledge of the Microsoft Office suite of products required; d. Strong telephone communication and organizational skills required. e. Ability to work in an office environment with moderate noise level, ability to work flexible hours, including evenings and weekends, and the ability to travel to other offices and client, carrier, and work sites, as required; and, f. Residency in the State of New Jersey in accordance with the New Jersey First Act, N.J.S.A. 52:14-7, et seq., unless otherwise exempted. The wage range for this position is $39,918.28-$52,143
Job Type:
Full-time Pay:
$39,918.28 - $52,143.00 per year
Benefits:
Dental insurance Flexible spending account Health insurance Life insurance Paid time off Retirement plan Tuition reimbursement Vision insurance
