Claims Coordinator

USRC's greatest strength in being a leader in the dialysis industry is our ability to recognize and celebrate the differences in our diverse workforce.

We strongly believe in recruiting top talent and creating a diverse and inclusive work climate and culture at all levels of our organization.

SUMMARY

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.

Essential Duties and Responsibilities include the following.

Other duties and tasks may be assigned.



* 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