Claim Operations Specialist - (Rancho Cordova, CA)

Primary Job assignments & Responsibilities Customer Engagement: Serves as a customer service representative for the claim department by promptly and professionally addressing external and internal customer questions and concerns, which may include: Triage and route callers to the appropriate department. Answers claim status and payment questions. Claim Operational Service and Partnerships: Partners with claim professionals in multiple departments to assist with the timely resolution of claims, which may include: Properly documents claim files, including notes and diaries. Corrects wage statements. Requests police reports and medical records. Reviews medical bills for proper billing and coding. Prints and prepares claim documents for legal and medical reviews. Reports claims to other insurance companies. Assigns new claims to the appropriate claim professional. Transitions closed files to and from off-site storage using records management systems. Receives, sorts, scans, and uploads incoming mail.