Administrative Specialist

ABOUT INSURANCE ADMINISTRATIVE SOLUTIONS
Insurance Administrative Solutions (IAS) is a third-party provider of comprehensive administrative solutions for our clients in the insurance industry. We offer a business process outsourcing solution that helps insurers optimize administrative workload, bolster their industry expertise, leverage emerging technologies, and streamline operations. With strong industry knowledge, we deliver value to our customers by providing compassionate customer service, efficient processing, and quality results. Here at IAS, we embrace the fact that great things are only accomplished by working as a team. We believe that all of our employees have valuable input no matter the level. Our highly collaborative team environment offers each of our employees a place where they can excel.

Job Summary: The Administrative Specialist manages processes for several areas of the claims office.  Key areas for this position include, but are not limited to, medical record requests for major claims adjusters, policy owner service call reception and completion of resulting service items, auditing and preparation of medical record billing for payment approval, agent contracting and appointment support, working with carrier marketing group, and various other word processing tasks.

Medical Record Requests: Exercising proper management of the ordering and procurement of medical records and other pertinent documents for major claims adjusters; maintaining a detailed and organized tracking system for these documents.

Medical Record Billing: Weekly and monthly review of different billing cycles regarding billing received for medical records. Both processes including the auditing and preparation of invoices for approval and payment by the office Director and Corporate Accounting. Documentation of invoices received requires detailed reporting to trace the payment process for each bill so that cost analysis may be conducted by other associated departments.

Policy Owner Service: Providing prompt, courteous customer service which meets or exceeds service standards; concentration in the area of policy cancellation, demographic changes and banking changes which require the use of appropriate written correspondence and internal procedures to document any editing of an insurance policy electronic file.

Agent Licensing: Agent contracting and appointment support and customer service including requesting background checks, working with carrier marketing groups and processing daily, monthly, and annual contract submissions and terminations including initial and renewal appointments for agents.  Review and update agent contracts and appointments from client e-mails and phone requests.

Word Processing: Editing and creation of internal work documents, external letters and some reporting as needed by the Director. Tasks vary and will be completed on an as-needed basis in an evolving claims office where processes are developing with changes in workflow. Focus is to always seek streamlining of processes and to promote greater efficiency.

Primary Responsibilities Other duties as assigned:

• Read and understand medical records and be familiar with physician/hospital billing.
• Process incoming provider correspondence.
• Create and maintain Excel spreadsheets.
• Make or receive phone calls to and from providers.
• Create and send correspondence to providers via mail, email or fax. Fully document all correspondence and related materials as to leave a clear and concise audit trail.
• Process customer request using internal and client-mandated procedures with a focus on proper documentation of all insured interactions including call tagging, policy notes and letter processing.
• Decipher and audit invoices against medical records received for accuracy; creation of billing packets / documents for Director approval and submission to Corporate Accounting.
• Documentation of all invoices both submitted for payment and check copies for invoices paid.
• Creation of documents across multiple platforms for both internal and external use: letters, spreadsheets, etc.
• Review Agent Onboarding Packets
• Support initial contracting of agents selling supplemental health products
• Process state appointments upon request
• Renew and terminate agent appointments
• Answer phone calls/inquiries from the marketing organization regarding contracts, background checks, and appointments
• Identify, research, and correct any issue caus