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Grinnell Mutual Reinsurance

Location: Grinnell, Iowa
Experience: 5 - 10 years
Education: Bachelor's Degree
Wage: Salaried
Type: Full Time
Shift: 1st - Day
Open: 06/16/2017
Close: 07/31/2017

Claims Technical Specialist

Subject matter expert within the claims division who acts as a resource for troubleshooting and training Claims processing systems, Qlikview and Medicare Compliance Regulations. Questions may vary in complexity from the simplest to the most difficult.

Please note that candidates need to be eligible to work in the U.S. without Grinnell Mutual sponsorship.

Job Duties and Responsibilities:
•Researches and analyzes issues identified by Claims users of the Claims processing system. Evaluates concerns to determine whether issue is related to actions of the user or technology and recommends solutions. Maintains documentation related to issue of concern and solution implemented to provide reference and history to other users.
•Performs system testing and works with business users to determine if the system functions correctly and meets all the established requirements. Creates and tests user documentation including reference and training materials.
•Serves as a liaison between Claims and the ES Claims Processing team by writing detailed written specifications for ES Content Management Team related to projects needed by claims team. Performs user acceptance testing as project or upgrade is completed and relays information to claims.
•Provides user support and training through direct contact with users via phone, e-mail or in person. Evaluates users’ knowledge gap through self report, observation, and supervisor’s information. Support provided to all claims processing system. Develops and delivers material both in one-on-one setting and groups. Follows up to ensure transfer to work assignments. Trains individuals of all skill and professional levels within the claims division.
•Analyzes and identifies processing/application system inefficiencies and recommends improvements after researching and understanding possible impact to users of all levels. Uses logic, personal judgment, and known facts and figures to explore solutions. Presents alternatives to supervisor in a manner that outlines pros and cons of each alternative.
•Researches, analyzes and delivers data results to users as requested by using Qlikview and queries.
•Medical Task Force liaison by monitoring Medicare Compliance changes, attending task force meetings, communicating with and relaying information provided by our outside Medicare contacts, keeps the task force well informed of changes as soon as they are known.
•Performs other duties as assigned.

Knowledge, Skills, and Abilities:
•Bachelor's degree (B.A) from four-year accredited college or university and five years property/casualty claims experience; or equivalent combination of education and experience. AIC or SCLA designation preferred.
•Ability to demonstrate strong interpersonal, active listening and customer service skills to diagnose issue of concern. Asks probing questions and may observe users while working to determine whether concern is related to a system or a user error. Acts with diplomacy and consideration when evaluating request and providing solution.
•Ability to professionally present information and respond to questions in one-on-one or group settings. Communication may be via the telephone, in person, or in written correspondence. Ability to relate information to both technical and claims audiences and ensure understanding.
•Ability to organize work, determine priorities, and meet deadlines established while experiencing frequent interruptions. Must be able to manage and set priorities for multiple and/or conflicting deadlines.
•Ability to understand basic insurance terminology applicable to personal lines and commercial lines of insurance. Strong working knowledge of the relationships between claims procedures and workflow.
• Ability to work with a team to determine business technology needs and recommend solution resulting from team decision.
•Ability to determine project timelines by analyzing project specification, gives realistic estimate to end user and follows through by meeting deadlines.
•Demonstrated aptitude for technology and ability to apply new concepts quickly and efficiently. Operates basic office equipment, including computers, utilizes specialized claims applications and Microsoft Office applications. Strong working knowledge of Claims processing or other content management system with the ability to share knowledge with others.
•Ability to work with minimum supervision. Keeps a regular work schedule and maintains regular, predictable attendance.
•Ability to work in a harmonious manner with co-employees, customers, agents and supervisor.
•Ability to maintain a valid driver’s license to allow flexibility to travel on occasion to users’ in-home offices, claim sites and/or professional development opportunities.

Supervisor Responsibilities:
•No supervisory responsibilities assigned.

Responsibility & Decision Making Authority:
•Recommends solutions related to Claims system changes and works in concert with Director to determine the best solution and introduction to workgroup.

Fiscal Responsibility:
•No direct budgeting or fiscal responsibilities.

Contacts (Internal, External)
•Primary internal contact is with BIS Content Management team and all levels within the direct claims division. May occasionally work with other internal departments related to the work of claims.
•Limited external contact.

Working Conditions and Physical Efforts
•To perform this job successfully, an individual must be able to perform each job duty and responsibility satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform job duties and responsibilities.
•The work may be stressful, especially when managing multiple projects, when working with many types of individuals, or when faced with tight deadlines. May be required to work overtime to accomplish work.
•Responds to user requests and calls related to Claims system and workflow processes causing interruption to work and the need to balance multiple priorities. Workload may be heavier in times when claim load is heavier.
•During times of conversion or system implementation, may be required to work weekends or non-typical work hours to perform system checkout procedures to verify correct implementations.
•The position is physically located in the home office with a work environment of a typical office setting; noise level is relatively quiet and occasional stress is encountered as deadlines approach. The position requires an individual to sit for long periods of time. Computer use is frequent with large amount of keyboarding, mouse utilization, and eye strain related to computer monitor.

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This job description is not intended to describe, in detail, the multitude of tasks that may be assigned, but rather to give the employee a general sense of the responsibilities and expectations of his/her position. As the nature of the business demands change, so too may the job duties and responsibilities.