Claim Clerk, Senior (In-Office)

At CCMSI, we look for the best and brightest talent to join our team of professionals. As a leading Third Party Administrator in self-insurance services, we are united by a common purpose of delivering exceptional service to our clients. As an Employee-Owned Company, we focus on developing our staff through structured career development programs, rewarding and recognizing individual and team efforts. Certified as a Great Place To Work, our employee satisfaction and retention ranks in the 95th percentile.    

Reasons you should consider a career with CCMSI:

• Culture: Our Core Values are embedded into our culture of how we treat our employees as a valued partner-with integrity, passion and enthusiasm.
• Career development: CCMSI offers robust internships and internal training programs for advancement within our organization.
• Benefits: Not only do our benefits include 4 weeks paid time off in your first year, plus 10 paid holidays, but they also include Medical, Dental, Vision, Life Insurance, Critical Illness, Short and Long Term Disability, 401K, and ESOP.
• Work Environment: We believe in providing an environment where employees enjoy coming to work every day, are provided the resources needed to perform their job and claims staff are assigned manageable caseloads.

The Claim Clerk, Senior will provide general clerical duties for the claim personnel and other team members as assigned.  Accountable for the quality of claim service as perceived by CCMSI clients and within Corporate Claim Standards.

1. Match mail for assigned accounts. 

1. Follow up on bills. 

1. File claim mail and related documents. 

1. Set up designated claim files and complete all set up instructions, as requested. 

1. Back-Up for Receptionist. 

1. Summarize correspondence and medical records in the claim log notes as wells as file it in the appropriate claim, as directed by claim staff. 

1. Retrieve closed files and re-file in storage. 

1. Maintain claim files in storage. 

1. Photocopy claim documents, as needed. 

1. Return provider calls or other calls, as directed. 

1. Provide support to claim staff on client specific teams. 

1. Compliance with service commitments as established by the team. 

1. Provide oversight and train new clerks on claim setup and any other duties. 

1. Assist in the workload management of new claim submissions / claim setup to ensure no disruption in service. 

1. Assist Claim Clerks with issues related to claim setup, including additional contacts to account managers and underwriting. 

1. Provide workflow suggestions to improve service. 

1. Performs other duties as assigned.

Must have been in the Claim Clerk position for a minimum of two years.

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, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Excellent oral and written communication skills. Individual must be a self-starter with strong organizational abilities.  Ability to coordinate and prioritize required.  Ability to operate general office equipment and perform clerical duties. Flexibility, initiative, and the ability to work with a minimum of direct supervision a must.  Discretion and confidentiality required.  Ability to work as a team member in a rapidly changing environment.

Reliable, predictable attendance within client service hours for the performance of this position.

Responsive to internal and external client needs.

Ability to clearly communicate verbally and/or in writing both internally and externally.

Education and/or Experience                                                            

High school diploma or equivalent.

Computer Skills             

Proficient with Microsoft Office programs. 

Certificates, Licenses, Registrations 

None required.

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.

Object Handling Categories

Work requires the ability to lift/carry objects routinely as follows:

Light Lifting:          No lifting of objects weighing more than 15 pounds on a regular basis.

Other Physical Demands 

Work requires the ability to sit or stand up to 7.5 or more hours at a time.

Work requires sufficient auditory and visual acuity to interact with others

CORE VALUES & PRINCIPLES

Responsible for upholding the CCMSI Core Values & Principles which include: performing with integrity; passionately focus on client service; embracing a client-centered vision; maintaining contagious enthusiasm for our clients; searching for the best ideas; looking upon change as an opportunity; insisting upon excellence; creating an atmosphere of excitement, informality and trust; focusing on the situation, issue, or behavior, not the person; maintaining the self-confidence and self-esteem of others; maintaining constructive relationships; taking the initiative to make things better; and leading by example.

CCMSI is an Affirmative Action / Equal Employment Opportunity employer offering an excellent benefit package including Medical, Dental, Prescription Drug, Vision, Flexible Spending, Life, ESOP and 401K.