Customer Service Claims
Portland, ME 04101
Under the general direction of the Claims Services Manager, provides clerical and technical support to the Claims Department. This position has no supervisory responsibilities.
- Process and distribute mail and fax correspondence for the Claims Department.
- Daily filing of correspondence to ensure updated claim files.
- Management of medical records files to include setting up, filing, copying, scanning, saving, sending and destroying.
- Answer and/or retrieve messages from the call pool
- Type and transcribe internal file memos, outgoing correspondence, and recorded statements as well as providing back-up assistance with transcribing Claims Committee meeting minutes when necessary.
- Provide back-up assistance for departmental clerical responsibilities.
- Compose routine and topic-specific correspondence as requested by the Claim Representative.
- Accept new claim calls from physicians and institutional insureds, record basic pertinent data for follow-up by Claim Rep.
- Schedule appointments and maintain calendar for Claim Representatives.
- Develop familiarity with and maintain assigned claim files. Diary items for follow-up.
- Set up and/or enter new claim files for all lines of business, to include:
- review and confirmation of physician coverage on all new claim reports
- fill in all data fields upon receipt of all pertinent data
- completion of mandatory reporting documents internally/externally
- Prepare and process all indemnifications reportable via on-line to NPDB.
- Process file closures.
- Process summary updates for Claims Committee packet and aid with its completion.
- Aid with processing Claims Department invoices for payment and complete data entry of same into AP system.
- Process all work requests as submitted by Claim Reps to include verifying of authorization when necessary for reserve changes.
- Aid with processing CMS data on applicable files which includes gathering of pertinent data and entry of data into Oasis.
- Manage the input of data into Oasis with regard to Attorney Firm and Attorney case handling in order to provide accurate data for the Attorney Assignment Reports.
- Maintain the on-line Claims Oasis Training Manual.
- Interact in a courteous and friendly manner with all MMIC employees, policyholders, and outside vendors; establish positive relationships.
- Perform any other assigned projects, tasks or activities to enhance the overall operations of Medical Mutual Insurance Company of Maine.