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Administrator - Claims Service

The purpose of this position is to process basic claims and correspond with insured and providers in a prompt, informative, and courteous way.

The incumbent in this role also interacts with other departments in order to obtain information needed to process claims.

The position works within established procedures applying basic understanding of a body of knowledge.


Claims Processing

* Reviews claim requests to determine eligibility for processing and escalate to management as necessary.

* Makes appropriate system entries and verifies accuracy.

* Ensures utilization of most up to date processes and procedures to update claims.

* Identifies process improvements, offers solutions to claim problems, and communicates recommendations to management.

* Manages tasks according to company guidelines.

Client Inquiries

* Responds within company standards to inquiries by telephone and written communication.

* Works with colleagues across the organization to research inquiries in a prompt, courteous, and accurate manner.


* High school diploma or equivalent required

* Claims processing and/or medical office experience preferred.

No claims experience required.


* Excellent written and verbal communication skills to effectively interact with customers on the telephone.


* Excellent organizational and time-management skills to handle multiple tasks.


* Detail oriented to ensure accuracy.


* Analytical skills and the ability to make appropriate decisions independently.


* Basic computer skills and the ability to navigate through multiple systems without assistance.


* Proficient in Microsoft Office.


* Appropriate license must be obtained if necessary for position.

Core competencies include: 

* Critical Thinking and Problem Solving 

* Professional/Technical Knowledge 

* Communicating with Impact

* May need New York Adjustor's license (only need 3 licensed for state of New York)

Mercer delivers advice and technology-driven solutions that help organizations meet the health, wealth and career needs of a changing workforce.

Mercer's more than 22,000 employees are based in 43 countries and the firm operates in over 130 countries.

Mercer is a wholly owned subsidiary of Marsh & McLennan Companies (NYSE: MMC), the leading global professional services firm in the areas of risk, strategy and people.

With more than 60,000 colleagues and annual revenue over $13 billion, Marsh & McLennan helps clients navigate an increasingly dynamic and complex environment.

Marsh & McLennan Companies is also the parent company of Marsh,which advises individual and commercial clients of all sizes on insurance broking and innovative risk management solutions; Guy Carpenter, which develops advanced risk, reinsurance and capital strategies that help clients grow profitably and pursue emerging opportunities; and Oliver Wyman, which serves...