Casualty Claims Examiner Assistant

MMG INSURANCE COMPANY

Job Description

Job Title: Casualty Examiner-Adjuster Assistant

Department: Casualty Claims Department

Reports To: Manager

FLSA Status: Non-Exempt

SUMMARY

Supports Casualty Examiner and Adjuster positions by performing clerical functions related to claim file set-up, drafting correspondence and maintaining files. Obtains pertinent information, medical records and medical bills to support Examiner and Adjuster positions in claims’ handling.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Sorts, prioritizes, and routes both electronic and postal service mail.
• Organizes electronic claim files and updates diary.
• Requests, in writing or verbally, and obtains various records and reports in connection with claims' investigations and evaluations.
• Indexes, reviews, itemizes and summarizes medical bills and records.
• Indexes and drafts correspondence.
• Assists clerical staff with mail, payments and loss notices.
• Handles overflow claim’ assignments.
• Requests information from medical providers, attorneys and other vendors, as needed.
• Requests records and policy/fire reports.
• Travels to fulfill educational requirements. (May include overnight stays.)
• Other duties may be assigned.

SUPERVISORY RESPONSIBILITIES

This job has no supervisory responsibilities.

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION and/or EXPERIENCE

Associate's degree; or equivalent combination of education and experience.

Prefer education and/or experience in paralegal work or medical records' transcription.

LANGUAGE SKILLS

Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings. Writes clearly and informatively; Edits work for spelling and grammar; Able to read and to interpret written information.

MATHEMATICAL SKILLS

Ability to add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions and decimals. Ability to compute rate, ratio and percent.

REASONING ABILITY

Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem-solving situations; Uses reason even when dealing with emotional topics.

COMPUTER SKILLS

To perform this job successfully, an individual should have knowledge of Office Productivity software such as Spreadsheet, Word Processing, and Communication software, and claims-related processing software.

CERTFICATES, LICENSES, REGISTRATIONS

The Company may require the employee to acquire, within a reasonable period of time as established by the Company, adjuster’s licenses for any/all states in which the Company does business.

The Company may expect the employee to acquire the Associate in Insurance Claims (AIC) designation sponsored by the Insurance Institute of America.

The Company may expect the employee to take other courses it deems appropriate to the employee's duties and responsibilities.

OTHER SKILLS AND ABILITIES

• Possesses good telephone skills.
• Possesses good interpersonal, relationship skills.
• Must possess good typing, keyboarding, word processing speed and accuracy.
• Customer Service – Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
• Professionalism – Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments.
• Demonstrates the ability to consistently maintain a positive attitude.
• Works cooperatively and productively with employees.

OTHER QUALIFICATIONS

Teamwork – Balances team and individual responsibilities; Exhibits objectivity and openness to others’ views; Gives and welcomes feedback; Contributes to building a positive team spirit.

Demonstrates an aptitude consistent with securing information, analyzing it and making good decisions affecting the position's area of responsibility.

Judgment – Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel; and talk or hear. The employee is occasionally required to stand; walk; reach with hands and arms. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception, and ability to adjust focus.

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee may occasionally be exposed to outside weather conditions. The noise level in the work environment is usually quiet