Primarily responsible for supporting the document management including media by analyzing, processing, indexing, re-indexing and assigning a document type and/or sub-doc type to all documents received by all departments within the Enterprise. Documents are received via OnBase and/or paper, fax, media and email. The incumbent must distinguish what department a document belongs to, apply proper criteria to electronically route the document into an electronic database, and initiate workflow of these documents to appropriate core business units in an accurate and timely manner. Primary contacts include other departmental personnel, as well as external vendor contacts. This role is also responsible for processing of incoming documents for the Subrogation, Legal, Commercial Auto, Fronting Agreements, Assigned Risk, Regulatory, Investigations and Medicare/Medicaid teams. Subject matter expert for Document Specialists and Claims Document Analysts.
PRIMARY RESPONSIBILITIES:
Performs computer inquires through multiple systems for other departments, including all groups within the Enterprise.
Responsible to assist CDAs with the following and serve as a subject matter expert:
Analyzes incoming documents (physical/faxes/emails) supporting the critical workflow within the Enterprise.
Reviews specialized documents and adds pertinent information to the document keywords and to appropriate data fields in the claim system
Re-indexes and appropriately routes documents that have been assigned an improper document type or have been attached to an incorrect claim (Error Que)
Adds legal matters and pertinent litigation information to the claim system upon receipt of legal documents
Sets priority activities to core business units including but not limited to Finance, Subrogation, Legal, Fronting Partners, Assigned Risk Claims & Policy and Commercial Auto Claims and Policy as appropriate upon receipt and review of documents
Performs other duties and special projects as requested by leadership.
Assists with the creation of procedural documentation and workflows.
Contacts employer or provider via email/phone if necessary, to obtain information.
Opens, sorts, prepares, bundles, scans, process and validates/verifies physical and electronic mail for all departments daily.
Determines appropriate criteria to accurately index an electronic image to initiate critical workflow to the proper department within the Enterprise. (AR, Commercial Auto, Fronting)
Completes special handling as necessary for the scanning, logging, and validation of all incoming checks including Assigned Risk checks.
Uploads, converts, and logs media files and formats into electronic database (i.e. surveillance videos, recorded statements, records on CD, claimant's personnel files, etc.).
Use of cloud-based applications to retrieve necessary information through a web browser (i.e. surveillance videos, invoices etc.)
Assist with mailroom support functions when necessary.
Maintains scanning equipment in appropriate working order according to documented guidelines.
Maintains records according to the corporate retention guidelines.
Assists with email routing and uploads, including documents sent to quality control queue.
Serves as subject matter expert for new staff members, as well as both internal and external customers.
Assists Quality Specialist with document imaging workflow and other Quality Specialist duties as needed.
Coordinate the efficient transfer of imaged or physical documents.
Identifies, researches, and resolves issues, errors and document transmission problems.
This description identifies the responsibilities typically associated with the performance of the job. The percentage of time in any responsibility may vary between positions. Other relevant essential functions may be required.
EMPLOYMENT QUALIFICATIONS:
EDUCATION REQUIRED:
High school diploma, G. E. D. required with additional 12 credit hours of course work in business or insurance.Combinations of education and experience may be considered in lieu of additional training or coursework.
EXPERIENCE REQUIRED:
Minimum two years general office experience that includes relevant experience reviewing and providing specific document types to scanned images. Including one year of experience as a Document Specialist and/or Claims Document Analyst.
SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:
Ability to file alphabetically and numerically and organize by document type.
Ability to be well organized and maintain an organized work environment.
Ability to identify documents.
Ability to enter alpha/numeric data accurately and timely.
Ability to lift or move objects weighing up to 35 lbs. or more repeatedly.
Ability to maintain confidentiality and document security.
Ability to follow established procedures.
Ability to perform mathematical calculations with the ability to use a ten-key pad with accuracy.
Ability to work with others.
Proficiency with related retention guidelines.
Ability to transfer, format and convert multiple media files.
Excellent verbal and written communication skills.
Excellent customer service skills.
Basic knowledge of computers and spreadsheet software.
Basic knowledge of word processing software.
Ability to verify data for accuracy
Ability to work effectively with specialized business units. (Legal, Subrogation, Assigned Risk, Regulatory, Medicare/Medicaid, Investigations and Commercial Auto)
Ability to be an independent thinker to solve issues.
Ability to manage multiple priorities and meet established deadlines.
Excellent organizational skills and ability to prioritize work.
Basic knowledge of medical and legal terminology.
Ability to coach and mentor others to perform the core responsibilities
Ability to assist with the creation of procedural documentation and workflows.
Ability to multi-task i.e. interacts on telephone while entering data
Knowledge of using hand break and compressed zip files
Knowledge of continuous updates for Fronting Partners and researching information in applicable systems
Knowledge of keywords for subtyping pertinent information for claims documents Demonstrated document expertise with Legal, Subrogation, Assigned Risk, Regulatory, Medicare/Medicaid, Investigations and Commercial Auto departments
Knowledge of insurance, medical, and state/legal documents.
One (1) year of previous experience working with prepping, scanning, and indexing of records in the insurance industry. Experience working with scanned images/document management system.
Certified Authority on Workers' Compensation (CAWC)
WORKING CONDITIONS:
Work is performed in an office setting with no unusual hazards. Work typically involves sitting at a desk for extended periods of time with extensive document handling, both physically and electronically. May be required to move or lift objects weighing up to 35 lbs.
REQUIRED TESTING:
Alpha numeric data entry, Reading Comprehension, 10-key, Basic windows, Basic Excel, Math
