Guidesoft Inc. dba Knowledge Services

49665 Claims Analyst

3 weeks ago
Job ID
2017-9731
Job City
Nashville
Job State
Tennessee

Overview

Knowledge Services is seeking a Claims Analyst 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. 

Responsibilities

  • Investigates claims assigned by the supervisor to determine eligibility in accordance with the Criminal Injuries Compensation Act.
  • Must effectively communicate both written and verbal requests for information from claimants, attorneys, law enforcement, medical providers, employers, members of the district attorneys’ offices, etc.
  • Must develop a thorough knowledge of the statutory law governing the compensation program and any other pertinent statutory provisions related to review of claims.
  • Evaluates supporting documentation (e.g., medical bills, treatment notes, offense reports, lost wage verification, and permanent disability determinations) and continually monitors claim progress as materials are received to determine compensability under the program.
  • Speaks with claimants, attorneys, medical providers, law enforcement, victim-witness coordinators, District Attorneys, employers, insurance providers, and other professionals regarding supporting documentation. Continually monitors deadlines of claims to maintain productivity and efficiency, then evaluates claims as soon as is possible based on file information.
  • Makes informed, proper recommendations for approval or denial of claims in accordance with guidelines set forth in the law, including financial calculations. Works in a digital and electronic workflow environment for file and document management. Performs very detailed word processing and spreadsheet tasks and works on claims tracking/payment software.
  • Responsible for effective individual case management and organization, including resolving any issues on claims relative to reviewing files on microfilm, posting refunds, etc. Responsible for explaining the claims process to anyone inquiring and providing a professional, sensitive, quality-oriented claims process.
  • Must provide appropriate and timely customer service to the customers of the office.
  • Performs any other duties as assigned by the supervisor or director.

M-F 8-4:30

Pay $17.50/hr

Parking not included

 

 

Qualifications

  • Graduation from an accredited four-year college or university with a bachelor's degree and 1 year of professional experience, or graduation from an accredited four-year college or university with a bachelor's degree and a paralegal certification.
  • Microsoft Office
  • Experience working with claims

 

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