This is an entry-level position. This position leads to a Medical Only Claims Specialist I and is expected to last up to 12 months. Upon completion of the training plan the incumbent is expected to be proficient with the Medical Only Claims policies, processes, procedures, and terminology related to the job. In addition, the incumbent will be proficient in the job responsibilities and tasks of the Medical Only Claims Specialist I position description. The incumbent will be evaluated on their progress and successful completion of the training plan each quarter. Upon satisfactory completion, the incumbent will be eligible for the Medical Only Claims Specialist I position. Medical Only Claims Associate will work with all members of the team and may receive direction, support, and instruction from the Manager or Medical Only Claims Specialists depending on the assignment.
This description identifies the responsibilities typically associated with the performance of the job. The percentage of time in any responsibility may vary between positions. Other relevant essential functions may be required.
EDUCATION REQUIRED: .
High school diploma
2 years insurance experience (Could add finance, medical, or any other applicable experience)
Associates degree in insurance, business administration, health administration and/or related field. Combination of education and experience may be considered in lieu of a degree.
SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:
ADDITIONAL EDUCATION, EXPERIENCE, SKILLS, KNOWLEDGE AND/OR ABILITIES PREFERRED:
Work is performed in an office setting with no unusual hazards.
Reading Comprehension, Typing 35wpm, Basic Word, Math and Proofreading.
Internal Candidate: An incumbent who does not successfully obtain a MI or TX licenses at the end of the 180 days will not be placed in a MOCS role. If the Company is unable to return the incumbent to a bargaining-unit job the incumbent will then be placed on the recall list in accordance with Article 8.8 of the Collective Bargaining Agreement.
External Candidate: Initial probationary period 180 days. Successful completion of probationary period requires adjuster license obtained in either MI or TX.
An incumbent who does not successfully complete the training plan at the end of the 12 months will not be placed in a Medical Only Claims Specialist I position. If the Company is unable to return the incumbent to a bargaining-unit job the incumbent will then be placed on the recall list in accordance with Article 8.8 of the Collective Bargaining Agreement.
At Emergent Holdings, we’re inspired to create, to challenge the status quo, to think not just about what our customers need now, but what they will need in the future.
We are strategic thinkers.
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Our diverse team of established industry experts embraces a culture of innovation and entrepreneurial spirit.
That means we’re focused on innovation, on leading and shaping our markets and improving health and safety for our customers and communities. For our customers, the result is a suite of solutions, services and products delivered ahead of market needs — and in anticipation of member demands.
We are tireless in our pursuit of the exceptional, and our companies deliver optimal customer experiences and improve people’s lives every day, by making workplaces safer and delivering affordable, solutions-focused healthcare services.