janine cunningham

Responsible for providing office and claims support for claims handlers or a unit. Including basic claims processing functions such as data entry, bill payments, completion and filing of forms and scheduling of appointments. Contact with clients, claimants and vendors to gather necessary information and complete file tasks. Processing of claims, including the review and authorizing of payments consistent with client requirements, company “Best Practices” and state regulations. Maintain effective and ongoing communication within the office and with outside parties. Set up new claims, establishes and maintains proper coding and data per company and client requirements. Maintains various claims processing and procedure records necessary to conduct business.

Responsible for providing office and claims support for claims handlers or a unit. Including basic claims processing functions such as data entry, bill payments, completion and filing of forms and scheduling of appointments. Contact with clients, claimants and vendors to gather necessary information and complete file tasks. Setting up claims and ensuring correct coding per state regulations. Ensure the timely payment of benefits, medical and vendor bills and processing state required filings. Plan and organize activities in a multi-tasking environment.

* Assures that all aspects of lower exposure claims are administered in accordance with all pertinent requirements, policies and procedures. * Effectively work with and obtain information from clients, claimants, vendors, the field and other internal or external resources. * Investigates losses to determine cause, scope and extent of damages and/or liability and possible subrogation. * Evaluate claim for purposes of setting reserves and making appropriate payments. * Documents all activity to support the outcome of the claim file. * Achieves fair, equitable and timely claim disposition that is consistent with our customer and internal expectations. * Communicates effectively with claimants, clients and other internal or external contacts. * Maintain positive relationships and create high level of satisfaction with clients

* Investigate, evaluate, dispose and settle less complex claims including the investigation, determination and evaluation of coverage, liability and damages and the setting of proper reserves. * Interact extensively with various parties involved in the claim process. * Handle claims consistent with clients' and corporate policies, procedures and "best practices" and also in accordance with any statutory, regulatory and ethics requirements. * Document and communicate all claim activity timely and effectively and in a manner which supports the outcome of the claim file.