Position Summary: The Support Specialist will identify specific processes, demands and peripheral procedures that slow or hinder the Aeromedical Case Manager and/or Claim Consultant’s ability to process cases/claims in a timely and efficient manner. Together, with the Case Manager and/or Consultant, the Specialist will mutually determine a support plan intended to ease the time and efficiency constraints imposed by these special needs.
Key Objective: While the Support Specialist will perform clerical duties, the position is intended to promote a team of well trained “specialists” who will operate as assistants to the Aeromedical and Claim Consultant Teams, helping them to achieve the goals and objectives specified for each assigned account.
Essential Functions and Responsibilities – Duties may include, but are not limited to the following:
• New Case/Claim Intake. Sets up and enters new cases and/or claims into proprietary case management database.
Retrieves documents from bin, email or fax, observe special instructions (if any), scans and loads into database (PDMS); verifies coding (Status, ICD9/10, other), enter data from applications, create case/claim file folders and route to consultant/case managers’ Inbox. Ability to summarize medical records is a plus.
• Back Diary Support. Conduct daily review of case manager/consultant task list and process overdue tasks until the tasks have been brought current. Collaborate with case/claim managers on any questions and/or details of the tasks from the back diary that is being updated.
• Enters and reviews notes/diaries in claims management database as instructed. Incoming mail or email (medical records and correspondence) is reviewed by Case Manager/Consultant and then routed to Support Specialist with corresponding file. Special Instructions will be included as necessary. Support Specialist will scan, load, stamp document as directed, enter notation into PDMS of what and when scanning was done, update fields from new correspondence and store records as directed.
• Route unmatched mail to Case Manager or Consultant for verification before scanning and storage is completed.
• Process invoices when routed from case manager/claim consultant.
• Account Implementation and Case Transfers. The Specialist will help with transition of newly acquired accounts, account / case transfers, incoming and outgoing claim shipments, placement and set up for filing, ongoing file cabinet maintenance, as well as general faxing and photocopying as requested by Case Managers/Consultants.
• Reviews, prepares, creates and /or mails letters, reports and forms. Assist with periodic mailings, issuance of case and/or claim packets and other information via regular mail, express mail, email or fax.
• Schedule Peer Reviews, MD Referrals and Independent Medical Examinations, as requested.
• Strong telephone skills, including upbeat voice and providing customer – focused answers; will initiate telephone calls, coordinate training meetings, claimant medical appointments, and provide customer service, as required.
• Other activities/projects as assigned including the preparation and distribution of computer reports.
• One (1) year or more, of clerical and customer service experience preferred
• High school diploma; some college and/or technical school training is a plus
• Knowledge of administrative systems, such as filing, form design and other office procedures and terminology
• Detail oriented, courteous, professional and strong problem solving skills.
NECESSARY KNOWLEDGE AND SKILLS:
• Excellent oral and written communication skills
• PC literate, including Microsoft Office products; data entry and strong organizational skills
• Ability to follow directions and respond positively to constructive feedback
• Ability to work in a team environment
• Ability to meet or exceed specified Performance Competencies