Claim Support Specialist

Our Promise To YouJoining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family: Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Schedule: Full time Shift: Day Address: 900 HOPE WAY City: ALTAMONTE SPRINGS State: Florida Postal Code: 32714 Job DescriptionResponsible for supporting the claims functions of the workers' compensation department by effectively communicating with injured employees, medical providers, employers, and legal counsel. This position utilizes multiple software programs, including Riskmaster, Perceptive Content, EDI systems, RxPlus, MedNet, Mitchell, and MS Office, to assist in claims administration. Additionally, this role handles tasks related to intake coordination, electronic data interchange, and document management. In addition, this position ensures accurate and timely processing of claims information. Contributes to the overall efficiency of the claims administration process through diligent and accurate performance of assigned duties. Intakes information on new claims from various sources and assigns new claims to the appropriate claim specialist level. Sends out new claim packages based on different jurisdictional requirements and fills in data fields. Alerts appropriate parties to all complex new claims. Collaborates with claim specialists to set medical appointments for injured workers. Communicates with all parties to ensure adherence to appointments and records all details in claim notes. Issues payments on bills and invoices, including prepayments, miscellaneous medical, mileage reimbursement, and defense bills while conforming with accounting standards and necessary documentation. Completes claim note documentation for medical visits upon request from claim specialists. Compiles and transfers specified documentation to defense counsel or medical specialists as requested. Reviews new Image Now documents, sets document types, links images to claims, and disseminates appropriately. Performs EDI extractions and submissions to various states when the EDI Claim Specialist is unavailable. Assists the Document Management team during times of high volume. Ensures accurate and timely processing of claims information. Knowledge, Skills, and Abilities: Demonstrated computer skills and the ability to learn RISKMASTER, Perceptive Content, MedNet, Microsoft Office Suite software programs [Required] Effectively communicate in the English language [Required] Ability to speak in Spanish [Preferred] Education: Associate [Preferred] Bachelor's [Preferred] High School Grad or Equiv [Required] Field of Study: or Equivalent Work Experience: Experience in a healthcare position [Preferred] Prior experience in workers' compensation [Preferred] Additional Information: N/A Licenses and Certifications: N/A Physical Requirements: This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. Pay Range: $17.63 - $28.20