Managed Care Claim Assistant I

AmTrust Financial Services, Inc.•Concord, CA

14d•Hybrid

About The Position

AmTrust Financial Services, a fast-growing commercial insurance company, has an opportunity for a Claim Assistant I within our Managed Care organization where your talent and abilities contribute to our competitive edge. The Managed Care Claims Assistant will perform a variety of support services to our Worker’s Compensation Managed Care department as described below, with oversight from Clerical Supervisor. The Managed Care Claims Assistant I maintains a solid understanding of AmTrust’s mission, vision, and values. Upholds the standards of the AmTrust and Claims organization. This role can be hybrid out of any AmTrust office

Requirements

High school diploma
Some college preferred
2+ years of experience in a worker's compensation case management department or related experience

Responsibilities

Processes treatment requests, referrals, and other activities as needed for Managed Care department following established methods to ensure compliance and privacy.
Reviewing records with high attention to detail regarding documentation and accuracy to determine eligibility of requests.
Generates letters from system templates, arranges distribution of response letters following proper handling procedures.
Coordinates with adjusters, nurses, and others as needed to obtain claims or clinical information necessary for processing or assignment.
Prioritizes requests and referrals based on review type, urgency of need while ensuring jurisdictional timeframes and department turnaround times are met.
Meets or exceeds industry standards of daily productivity while maintaining accuracy.
Accurately documents within multiple systems to reflect actions taken in response to referrals and requests.
Performs general maintenance of claims documents across various systems.
Adheres to any compliance changes as directed by supervisor.
Other administrative tasks as assigned.