Claim Support Specialist

Job Description

Job Description

A-G Specialty Insurance, LLC designs, markets and underwrites specialty sports, accident, and general liability insurance products. We have been in operation since 1983 and are nationally recognized as a leader in the sports insurance industry.

Job Summary

As a Claim Support Specialist, the incumbent will play a vital role supporting our Claim Services team. This role will involve administrative duties that are outlined below, to which is vital to the success of the claims process and will add efficiencies to the claims adjudication workflow as well as customer, client and provider satisfaction. The ideal candidate should be highly detail-oriented, precise, able to problem solve, as well as follow and interpret guidelines and requirements.

Essential Duties & Functions

Reasonable accommodations may be made to enable individuals to perform the essential functions.

• Attach policies for new claims and conducting coverage reviews
• Update claim detail data
• Operate from the Smart Data Solutions (SDS) portal when needed
• Creation of new claims and rollover claims; including but not limited to mandatory student accident policies (MSAP), and Intercollegiate Sports (ICS) policies
• Manage electronic incoming submissions and alternative workflows
• Retrieve necessary documentation for specific claims; including but not limited to itemized bills and explanation of benefits (EOBs)
• Open document clean-up in EGBAR (OAND report clean-up)
• Input provider Tax IDs in EGBAR
• Assist in response to A-G customer inquiries
• Generate payments for new claims
• Prep files for carrier audits
• Create database of provider contacts
• Other duties as assigned by manager or supervisor as related to the support of the Claims team.

Job Skills

Job Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and / or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Required / Preferred Education and Experience

Required Education : High School Diploma or Equivalent Experience

Preferred Experience : 1-3 years insurance experience, medical billing / coding experience, document management experience, customer service experience

Position Type and Expected Hours of Work

This is a full-time remote or hybrid position. Days and hours of work are Monday through Friday, 8 : 30 a.m. to 5 p.m. The schedule for this role can be contingent upon Supervisor and Human Resources approval. Some evening and weekend work may be required.

Travel

Limited travel would be encouraged for trainings or team meetings. This would be discussed ahead of time and agreed upon between both Supervisor and employee.

EEO Statement

A-G is committed to the principles of equal employment. We are committed to complying with all federal, state, and local laws providing equal employment opportunities, and all other employment laws and regulations. It is our intent to maintain a work environment that is free of harassment, discrimination, or retaliation based on the following protected classes : age (40 and older), race, color, national origin, ancestry, religion, sex, sexual orientation (including transgender status, gender identity or expression), pregnancy (including childbirth, lactation, and related medical conditions), physical or mental disability, genetic information (including testing and characteristics), veteran status, uniformed servicemember status, or any other status protected by federal, state, or local laws. A-G is dedicated to the fulfillment of this policy in regard to all aspects of employment, including, but not limited to, recruiting, hiring, placement, transfer, training, promotion, rates of pay, other compensation, termination, and all other terms, conditions, and privileges of employment. A-G will conduct a prompt and thorough investigation of all allegations of discrimination, harassment, or retaliation, or any violation of the Equal Employment Opportunity Policy in a confidential manner. A-G will take appropriate corrective action, if and where warranted. A-G prohibits retaliation against team members who provide information about, complain about, or assist in the investigation of any complaint of discrimination or violation of the Equal Employment Opportunity Policy.