Claims Assistant

The Claims Assistant will provide vital administrative support in processing and

managing insurance claims. This role involves organizing claim-related documents,

communicating with clients and insurance companies, and ensuring the accuracy and

completeness of claim information. Your work ensures that claims move efficiently,

helping both businesses and injured workers navigate the process with ease. 

• Organizes and maintains claim-related documents and records.

• Manages incoming mail, indexes claim documents, and maintains electronic

claim files.

• Inputs and updates claim information accurately in databases or software

systems.

• Communicates with clients, insurance companies, and other relevant parties to

gather necessary claim details.

• Requests and follows up on medical records, wage information, employer forms,

work status reports, and other outstanding documentation.

• Follows up on outstanding claims and obtains additional information as needed

for claims processing.

• Coordinates Independent Medical Examinations (IMEs), record retrieval,

surveillance, vendor assignments, and other claim-related services.

• Prepares and submits claim forms and documentation to insurance companies

within specified deadlines.

• Prepares and sends routine claim correspondence and state-required forms.

• Processes medical bills, reimbursements, and other approved claim payments.

• Manages diary items, monitoring follow-up items and administrative deadlines to

help keep claim activity current.

• Provides administrative support to claims adjusters or managers, including

scheduling appointments and managing correspondence.

• Provides Claims Information to insurers including billing information and adjuster

contact.

• Supports litigation and subrogation efforts by preparing referrals, gathering

documentation, and assisting with hearing or settlement preparation.

• Generates reports and spreadsheets to assist with claim tracking and department

metrics.

• Ensures confidentiality of sensitive claim information following privacy

regulations.

• Assists in preparing reports and presentations related to claim processing and

management.

• Performs other duties as assigned.