Duke Job Postings
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INSURANCE PAYMENT SPECIALIST
Job Title: INSURANCE PAYMENT SPECIALIST
Job Code: 0840
Job Level: 08
Revised Date: 06/18/2015
Job Family: JF 03
Perform the more complex insurance, accounting, office support and information processing activities involved in processing workers' compensation claims payments to claimants, medical providers, service providers, vendors, and others.
Coordinate and perform the more complex clerical duties and accounting tasks involved in the preparation and processing of workers' compensation claims payments and electronic file submissions to Duke Corporate Accounts Payable, Duke Employee Travel & Reimbursement, service provider partners, and the North Carolina Industrial Commission. Provide payment customer service to claimants, medical providers, service providers, vendors, and others. Provide information and answer inquiries concerning insurance and billing issues. Receive and reply to claims correspondence.
Administer incoming and outgoing electronic billing data exchange. Review and digitize incoming mail. Sort and distribute electronic billing documents to workers' compensation claims database.
Process wage replacement, medical, and vendor payments as approved by claims staff. Understand and apply procedures for medical bill review, vendor payment research, Duke manual payments, attorney payments, NCIC e-billing, payroll W-code, and check distribution (requires local travel to pick up and deliver checks). Provide administrative support to the claims staff regarding review, approval, submission, and payment of invoices of all types.
Generally provide administrative and clerical support to the department as required. Maintain accounting records of claims payments. Assist in maintaining claims and other files and in preparing reports.
Perform other related duties incidental to the work described herein.
The above statements describe the general nature and level of work being performed by individuals assigned to this classification. This is not intended to be an exhaustive list of all responsibilities and duties required of personnel so classified.
Required Qualifications at this Level
Work requires knowledge of general accounting and clerical principles generally acquired through two years of post-secondary education in accounting or a related business field.
Work generally requires 3 years of clerical accounting experience sufficient to acquire knowledge of the accepted practices involved in processing claims and maintaining records. OR AN EQUIVALENT COMBINATION OF RELEVANT EDUCATION AND/OR EXPERIENCE.
Basic to intermediate proficiency with Adobe Acrobat Professional, SAP, Excel, Outlook, insurance billing and payment applications, accounts payable procedures and applications, secure file transfer protocol (SFTP) applications, and electronic document management.
The intent of this job description is to provide a representative and level of the types of duties and responsibilities that will be required of positions given this title and shall not be construed as a declaration of the total of the specific duties and responsibilities of any particular position. Employees may be directed to perform job-related tasks other than those specifically presented in this description.
Duke University is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.
Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.
Essential Physical Job Functions
Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.