TIS Insurance
  • 21-Sep-2018 to 20-Mar-2019 (EST)
  • Knoxville, TN, USA
  • Salary
  • Full Time

Summary of Responsibilities:

Responsible for all aspects of claims processing, data analysis and lawsuit management for TIS Healthcare Services. TIS Healthcare clients encompass the following areas of the profession: Senior Housing, Home Health Care, Hospitals, and Physician Services. This position acts as a liaison between the agency and carriers and provides customer service claims assistance for our clientele. Our goal is to provide the highest degree of professional claims and related services through superior customer service and communication skills to our clients, carriers, and TIS Healthcare Services (HCS) Team Members.

 

This Job Description identifies and evaluates the major duties and responsibilities required of this position; however, it does not necessarily include all details of the position. Other duties considered within the scope of this position include administrative functions, such as information intake and correspondence, and occasional travel to interface with clients. TIS Healthcare Services reserves the right to assign additional duties as the need arises.

 

Reports to:      Traeon Beicher, Director of Risk Management Support Services

 

 

Preferred Qualifications:

  • Strong knowledge in claims handling, stressing prompt and effective customer service.
  • Proven track record in claims servicing, including management, supervisory or leadership positions.
  • Ability to maintain good interpersonal and working relationships with others.
  • Ability to understand and apply computer and communications technology applicable to this position.
  •  

Essential Functions:

    • Claims Processing, Reporting, on-going follow up, advocacy and handling the day-to-day Processes as needed.
    • GL/PL Claims
    • Auto Claims
    • Property Claims
    • Crime Claims
    • Boiler & Machinery Claims
    • D&O/EPL Claims
    • Builders Risk Claims
    • Umbrella/Excess Claims
    • Medical Records Requests
    • Summons & Complaints
    •  
  • Claim Updates

 

    • Litigated claims - follow up for answer filing and then every 60 days thereafter.
    • All claims follow up 7 days after reporting for carrier acknowledgement.
    • All non-litigated claims follow up every 90 days until claim closure.
    • Compliance with applicable laws including HIPAA regulations; strong risk management skills; stays abreast of changes in coverage; file documentation and performance of responsibilities with clients and others in a manner that avoids potential errors and omissions.
    • Litigation Processing, Reporting and on-going follow up.
    • Maintenance of Professional Liability Claims Logs.
    • Maintenance of Claims Contact Database.
    • Participates in trending reviews with Risk Management Support Services (RMSS).
  • Education, including self-study, to stay abreast of current insurance trends and broaden basic knowledge.

 

  • Licensing, if required, in accordance with statutory regulations or company requirements.
  • Marketing and Agent support.
    • Provide assigned account(s) claims detail to Senior Healthcare Claims Representative for use during pre-renewal strategy meetings.
    • Obtains and provides information regarding large losses for loss summaries.
    • Develop and follow through with the sending of cancellation/non-renewal letters regarding reporting requirements and ERP (Extended Reporting Period) options.
    • Claims Kits and Reporting Agendas processed and emailed to clients.
    • Client coverage trend reviews and the development of suggestions to Healthcare Services Team members for account review.
  • Coordinate and participate in Workers' Compensation Claims reviews as needed.
  • Identify and handle coverage issues according to HCS Claims Policies/Procedures.
  • Process large reserve notifications.
  •  

Knowledge, Skills and Abilities

  • In all dealings with clients, third parties, carrier claims personnel, co-workers and other business contacts:
  • Interact with others effectively by utilizing good communication skills and with full integrity, and provide information and guidance as needed, to achieve the business goals of TIS HCS.
    • Extend full courtesy and assistance in order to maintain a cordial and effective working relationship with others. Promptly respond to any request made, typically within 24 hours.
    • Personal organization and cordial communication skills necessary to understand and prioritize workload appropriately to meet timelines.
    • Ability to work autonomously and independently.
    • Set priorities and manage workflow to ensure efficient, timely, and accurate completion of duties and responsibilities.
    • Keep informed regarding emerging healthcare insurance and risk management-related industry information, including new products, legislation, coverages, and technological developments to continuously improve knowledge and performance.
  • Individuals must be able to meet established specific physical requirements of the job including sitting at a desk, reaching, lifting, pulling, bending, stooping, twisting, standing, and walking.

 

    • Ability to perform sedentary work, exerting up to 10 pounds of force occasionally, and exert negligible force frequently or constantly to move objects, including the body. May be asked to exert up to 20 pounds of force periodically, as needed.
    • Mental stress is expected from decision making, responding to client requests, problem solving and interruption of work schedule.

 

Full Job Description
TIS Insurance
  • Apply Now

  • * Fields Are Required

    What is your full name?

    How can we contact you?

    I agree to ApplicantPro's Applicant Information Use Policy.*
  • Sign Up For Job Alerts!

  • Share This Page
  • Facebook Twitter LinkedIn Email
.
Logo About Personal Business Bonds Claims Careers News Contact Login