Claims Administrator
Company: Morgan White Group
Location: Ridgeland
Posted on: May 25, 2023
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Job Description:
The Claims Administrator reports to the Claims Department
Manager in the MWG-Administrators TPA Division.The position is a
non-exempt, hourly role and is located at 500 Steed Road,
Ridgeland, MS 39157.GENERAL JOB DUTIES AND RESPONSIBILITIES:The
Claims Administrator will have a complete understanding of
insurance claims and coverage. This person will communicate with
all TPA Departments, Accounting, and auditors, as well as possibly
interacting with groups, claimants, outside carriers, and agents.
To perform the job successfully, the employee must be able to
perform each essential duty satisfactorily. The requirements listed
here are representative of the knowledge, skill, and ability
required. Reasonable accommodations may be made to enable
individuals with disabilities to perform the essential
functions.Performs all check related functions (Runs, refunds,
voids).Sends EOB and check files to third party for payment.Reports
Check Run Totals to Accounting.Maintains monthly record of claims
paid for account and auditing purposes.Processes claims paid
reports to the TPA, Marketing, Eligibility, Accounting, and
Auditors as requested.Ensures new group benefits are set up
correctly and sets benefits in CHS.Ensures group renewals are set
up correctly and updates benefits in CHS.Compiles data for
month-end and annual financial and compliance reporting.Reviews
returned checks and enters address corrections into the
administrative system(s).Handles ECHO voids/reissue of payments and
ECHO updates.Utilizes MWG-Administrators Policy Administration
System and Claims Management Software to verify eligibility.Inputs
data into MWG-Administrators Claims Management Software.Performs
other duties as assigned by the Department Manager.EXPERIENCE AND
EDUCATION REQUIREMENTS:High School Diploma or GED is required;
Associates or bachelor's degree is preferred.Must have previous
experience with data reporting and utilization of
spreadsheets.Insurance administration or insurance support
experience is preferred.Must have general computer skills and be
knowledgeable in MS Outlook, Windows, Excel, and Word.Must have
basic data entry skills and above average mathematical skills.Must
be able to learn and be proficient with the software used in the
TPA Departments.Must possess strong time management,
organizational, problem solving, and customer service skills.Must
work well under pressure with multiple priorities and meet
deadlines while maintaining a strong attention to detail.WORKING
ENVIRONMENT:Must be able to perform in a very high paced
environment while multi-tasking or handling interruptions.Must have
the ability to work independently while practicing effective time
management skills.Must be able to prioritize projects, work
multiple projects simultaneously, and meet project deadlines in an
organized manner.Must possess excellent problem-solving skills and
have keen attention to details.Strong written and verbal
communication, interpersonal, and relationship building skills are
required.Must be able to handle stressful situations
appropriately.Must maintain confidentiality and privacy in every
aspect of the job.JOB ESSENTIAL REQUIREMENTS:The following are job
functions that an employee must be capable of performing with or
without reasonable accommodation.Must be able to read, write, and
speak English; Spanish is a plus.Must be able to work as
scheduled.Must possess sight and hearing senses or use prosthetics
that will enable these senses to function adequately so that the
requirements of the position as stated above can be fully met.Must
be able to bend, stretch, reach, and sit or stand at a desk during
85% of the workday.Must be able to lift, stoop, and carry small
equipment items and supplies, possibly weighing up to 20lbs.MWG is
an Equal Opportunity Employer, committed to the principles of the
EEOC. All employment decisions are based upon each person's
qualifications, abilities, and performance. Our company works to
provide an environment where human dignity prevails and all
employees and applicants for employment receive equal consideration
and fair treatment, without regard to race, color, religion, age,
sex, national origin, disability status, genetics, protected
veteran status, sexual orientation, gender identity or expression,
or any other characteristic protected by federal, state, or local
laws. This policy applies to all terms and conditions of
employment, including recruiting, hiring, placement, promotion,
termination, layoff, recall, transfer, leaves of absence,
compensation, and training.
Keywords: Morgan White Group, Jackson , Claims Administrator, Other , Ridgeland, Mississippi
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