Claims Clerk

Claims Irvine, California


Description

Western Growers Assurance Trust (WGAT) was founded in 1957 to provide a solution to a need in the agricultural community — a need for employer-sponsored health benefit plans not previously available from commercial health insurance carriers. WGAT is now the largest provider of health benefits for the agriculture industry. The sponsoring organization of WGAT is Western Growers Association, created in 1926 to support the business interests of employers in the agriculture industry. WGAT’s headquarters is located in Irvine, California.

WGAT’s mission is to deliver value to agriculture-based employer groups by offering robust health plans that meet the needs of a diverse workforce. By working at WGAT, you will join a dedicated team of employees who truly care about offering quality health benefits and excellent customer service to plan participants. If you want to start making a difference working in the health care industry, then apply to WGAT today!

JOB DESCRIPTION SUMMARY

This position reports to the Supervisor, Claims Operations in a production environment and is responsible for supporting the claims department by preparing claim receipts and all related correspondence for the department.

QUALIFICATIONS

  • High School Diploma or equivalent and one year clerical or administrative experience within an office environment preferred
  • Strong verbal and written communication skills
  • Proficient 10- Key and typing capability
  • Basic knowledge of word processing and spreadsheet/end-user office software
  • Ability to work under pressure and adapt to changing environments
  • Ability to work overtime as needed.

DUTIES AND RESPONSIBILITIES


Clerical Support
  • Reviews and sorts incoming documents daily and prepares for imaging
  • Prescreens claims/correspondence on computer
  • Sorts documents and checks for distribution and/or mailing
  • Handles claims unable to forward to Examiners for processing
  • Serve as support for phone lines for reception, as needed
  • Enters alphabetic, numeric, or symbolic data from source documents, following the format displayed on screen
Quality Results
  • Maintains department standards and production goals
  • Complete logs, prescreening daily and timely
  • Communication and interaction to assure all work is completed and communicated with leadership
Reporting
  • Tracks/logs claims inventory
  • Return letters for incomplete information
  • Keeps record of work complete
Other
  • Utilize all capabilities to satisfy one mission — to enhance the competitiveness and profitability of our members. Do everything possible to help members succeed by being curious and striving to understand what others are trying to achieve, planning and executing work in a helpful and collaborative manner, being willing to adjust efforts to ensure that work and attitude are helpful to others, being self-accountable, creating positive impact, and being diligent in delivering results.
  • Other duties as assigned.

Physical Demands/Work Environment

The physical demands and work environment described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand, walk and sit. The employee is frequently required to use hands to finger, handle, or feel objects, tools, or controls and reach with hands and arms. The noise level in the work environment is usually moderate.