Guidesoft Inc. dba Knowledge Services

  • Claims Review Specialist

    Posted Date 1 week ago(12/4/2018 4:57 PM)
    Job ID
    2018-13128
    Job City
    Nashville
    Job State
    Tennessee
  • Overview

    Knowledge Services is seeking a Claims Review Specialist in Nashville TN.

     

    Knowledge Services,  established in 1994 and headquartered in Indianapolis IN, is a certified woman-owned (WBE) professional services organization with over 1500 employees located in offices throughout North America.  Founded by Julie Bielawski, CEO, Guidesoft, Inc. DBA Knowledge Services is an industry leader in Managed Service Programs (MSP), Employer of Record / Payrolling Services, National Recruitment, and Staffing Services.  We provide outstanding services to major organizations in various industries, including; IT, Healthcare, Entertainment, Media, Federal and State Governments, Public Utilities, Telecom, Manufacturing and more.

     

    As such, Knowledge Services is committed to providing opportunities for growth – in our company, in each team member and in our relationships.  We believe titles do not define a person, but provide a framework to each person’s endless potential.  Our focus on improving our team, product and processes drive us every day.  We are guided by our four Pillars that set the foundation of who we are and how we conduct business:  Knowledge, Integrity, Innovation, and Service. 

     

    Knowledge Services has benefit offerings to include the following!

     

    • Medical, dental, and vision coverage
    • Voluntary Life and AD&D coverage
    • Pet Insurance
    • Ticket and Event discounts!
    • The above are available provided contractors meet eligibility requirements

    Responsibilities

    This position performs tasks to intake, review and decide whether reimbursement is appropriate on criminal injuries compensation claims filed by victims and their relatives, as well as sexual assault forensic examination reimbursement requests filed by service providers.
    Key Responsibilities:

    • Works with victims, claimants, relatives, providers and others to explain the requirements for reimbursement, the process for reimbursement, and facilitates any part of that process that needs to be addressed on any claim filed. Some communications occur before a claim is filed.
    • Provides exceptional customer service in a sensitive, professional and meaningful way to various internal and external customers.
    • Explains and follows statutory, procedural and other requirements as needed to fulfill responsibilities which vary depending on the claim.
    • Reviews materials carefully to ensure that the appropriate decision is made relative to the eligibility requirements and that sufficient supporting documentation has been submitted to support any reimbursement.
    • Makes recommendations regarding eligibility and reimbursement, if applicable, for a supervisor to review.
    • Monitors responsibilities including, but not limited to, calls, correspondence and work queues, etc.

    Qualifications:

    • Graduation from an accredited four-year college or university with a bachelor’s degree.
    • Experience equivalent to one year of full-time professional experience.
    • Must have ability to communicate professionally and effectively with the public and co-workers to ensure high customer service standards.


    Works with victims, claimants, relatives, providers and others to explain the requirements for reimbursement, the process for reimbursement, and facilitates any part of that process that needs to be addressed on any claim filed. Some communications occur before a claim is filed.
    Explains and follows statutory, procedural and other requirements as needed to fulfill responsibilities which vary depending on the claim
    Reviews materials carefully to ensure that the appropriate decision is made relative to the eligibility requirements and that sufficient supporting documentation has been submitted to support any reimbursement.

     

    Pay $22/hr

    Parking is not included

    Business attire dress

    M-F 8-4:30pm

     

     

    Qualifications

    Bachelors Degree required

    Needed skill sets with these types of degrees:

    Legal/paralegal
    Social work
    History
    Political Science
    Business, general (not accounting)

     

    Skills needed for success:
    Strong written/verbal communication
    Strong organizational skills
    Strong time management skills
    Very detail oriented
    Professional and empathetic

     

    Physical Requirements:

    • Job frequently requires sitting, handling objects with hands.
    • Job occasionally requires standing, walking, reaching, talking, hearing, and lifting up to 25 pounds.
    • Vision requirements:  Ability to see information in print and/or electronically.

     

    We are an Equal Opportunity Employer. We do not discriminate on the basis of race, religion, color, sex, age, national origin or disability.

     

    INDADMDF

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