Managed Care Claim Assistant I
AmTrust Group

Job Info

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Overview

AmTrust Financial Services, a fast-growing commercial insurance company, has an opportunity for a Claim Assistant I within our Managed Care organization where your talent and abilities contribute to our competitive edge. This position is preferred as a hybrid office-based role, near an AmTrust office nationwide. The Managed Care Claims Assistant I perform a variety of support services managing medical networks/preferred provider organizations.

Responsibilities

• Managing medical provider rate agreement requests, including process, communication, and documentation
• Provider networks nomination routing and tracking, from customers, agents, and provider groups
• Tracking and resolution of escalated provider incidents
• Submitting nurse triage requests to vendor, along with postings and reference guides
• Medical bill pricing audit and validation, per defined contractual agreements
• Appropriately documents all system to reflect critical thinking and actions taken
• Coordinates with claims adjusters, nurse case managers, and external parties as needed
• Performing general maintenance and administrative tasks related to managed care documents, data entry, and process

Qualifications

• General knowledge of workers' compensation claims procedures and policies
• Ability to take direction, think critically, and make decisions
• Self-organized and detail oriented
• Ability to learn new procedures quickly and adapt to a changing environment
• Professional telephone demeanor and good oral and written communication skills
• Ability to work well under pressure and multi-task in a fast-paced environment
• Basic understanding of business technology
• Preferred basic understanding of medical terminology
• Preferred basic understanding of medical networks
• Ability to work in a team environment

Education:

• High school diploma
• Some college preferred
• 1- 3 years of experience in a worker's compensation claims department or related experience

This job description is designed to provide a general overview of the requirements of the job and does not entail a comprehensive listing of all activities, duties, or responsibilities that will be required in this position. AmTrust has the right to revise this job description at any time .

What We Offer

AmTrust Financial Services offers a competitive compensation package and excellent career advancement opportunities. Our benefits include: Medical & Dental Plans, Life Insurance, including eligible spouses & children, Health Care Flexible Spending, Dependent Care, 401k Savings Plans, Paid Time Off.

AmTrust strives to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected. This concept encompasses but is not limited to human differences with regard to race, ethnicity, gender, sexual orientation, culture, religion or disabilities.

AmTrust values excellence and recognizes that by embracing the diverse backgrounds, skills, and perspectives of its workforce, it will sustain a competitive advantage and remain an employer of choice. Diversity is a business imperative, enabling us to attract, retain and develop the best talent available. We see diversity as more than just policies and practices. It is an integral part of who we are as a company, how we operate and how we see our future.

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