Claims Coordinator

U.S. Renal Care•Plano, TX

About The Position

The Claims Coordinator assists the claims manager in overseeing the claims process from intake through resolution. This role is responsible for data entry, document management, claims tracking, and providing excellent customer service. follow-up, and customer service. The position plays a key role in ensuring claims records are accurate, complete, and up to date, while facilitating communication among internal teams, third- party administrators and external providers.

Requirements

Bachelor's degree preferred
Previous experience in Business Insurance; however, relevant experience may be considered.
Proficient with all Microsoft Office products, including Outlook and Word.
Interpersonal skills to interact with people at all levels, from staff to senior management.
Efficient, professional, and calm multitasking abilities.
Strong work ethic and organizational skills to work in a fast-paced, detail-oriented environment.
Flexibility to adapt to changing priorities.

Responsibilities

Receive and review new claims for accuracy and completeness; submit new claims as required.
Create and maintain organized up to date claim files.
Enter and update claim information in the claims system (Origami) including status updates and detailed notes.
Monitor claim files for payments, support documents and system uploads.
Pull medical reports and bills from provider website and distribute them to relevant parties.
Respond to claims inquiries and provide updates to internal and external stakeholders.
Answer questions on the claims portal; email workers' compensation forms to clinics or individuals without portal access.
Provide claims adjuster contact information and claim numbers as needed.
Coordinate and follow up on the required documentation, medical records and investigations.
Track outstanding information and escalate delays appropriately.
Follow up with brokers and thirds party administrators to ensure progress and accuracy.
Verify inquiry details and ensure data in workers compensation claims.
Initiate and support subrogation efforts as directed.
Support claims related projects and assist with departmental initiatives.
Foster effective relationships across departments while promoting a customer focused service environment.
Actively participate in team-based initiatives and ensure adherence to company policies.
Maintain regular and reliable attendance.
Actively promotes GUEST customer services standards; develops effective relationships at all levels of the organization
Participates in team concepts and promotes team effort; perform duties in accordance with company policies and procedures
Regular and reliable attendance is required for the job
Other duties as assigned