Job Duties Include But Are Not Limited To

Responsible for identifying and mitigating risks within insurance operations, ensuring smooth policy issuance and claims processing, and managing daily workflows to meet organizational deadlines. This role includes reviewing and optimizing operational processes, providing guidance to insurance staff and brokers, conducting performance evaluations, and fostering a collaborative work environment. The coordinator will implement strategies to enhance self-retention and strengthen relationships with medical providers and suppliers while ensuring strict compliance with insurance regulations and company policies. Staying informed on industry trends and regulatory changes, the coordinator will assist in budget planning, analyze financial reports, and collaborate with various departments to ensure accurate accounting and billing practices. Additional responsibilities include conducting data analysis to support strategic decision-making, coordinating claims support, and managing all insurance-related activities. The coordinator will efficiently process and monitor claims, act as a liaison with insurance providers, support departmental goals, handle policy endorsements, track renewals, and resolve payment issues. Proficiency in insurance software systems, meticulous record-keeping, and serving as the primary contact for all insurance matters are essential for this role.

• Identify and mitigate risks associated with insurance operations
• Manage day-to-day activities of the insurance section
• Ensure smooth functioning of policies issuance and claims processing
• Monitor workflow and delegate tasks effectively
• Review and improve operational processes for efficiency
• Supervise and provide guidance to insured staff and brokers
• Conduct performance evaluations and provide feedback
• Foster a positive work environment promoting teamwork
• Implement strategies for self-retention and relationship improvement with medical providers, suppliers, and brokers
• Ensure compliance with insurance regulations, policies, and procedures
• Monitor and assess risks, implementing risk mitigation strategies
• Stay updated on industry trends and regulatory changes
• Assist in budget planning and monitor departmental expenditures
• Review insurance financial reports and analyze performance metrics
• Collaborate with finance to ensure accurate accounting and billing
• Collaborate with other departments to ensure efficiency in insurance-related matters
• Conduct data analysis for decision-making and strategic planning
• Coordinate with insured employees for inquiries and provide assistance
• Organize and coordinate all insurance activities
• Submit claims statements timely for review and opening of claim files
• Process and track daily insurance claims
• Assist employees in medical insurance claims and ensure settlement
• Monitor and follow up on outstanding claims
• Act as liaison between Additional Named Insured (ANI) and insurance provider
• Collect and analyze insurance and claims data
• Track invoicing activity with insurers
• Support department goals and assist with insurance budget
• Ensure proper filing and documentation of insurance information
• Monitor patient employeesâ claims and maintain healthy aging AR
• Study insurance plans to understand nuances and communicate effectively
• Handle endorsements under existing insurance lines
• Track renewal dates of active insurance policies
• Analyze policy performance and report noncompliance
• Resolve payment delays and discuss denied coverage with insurance companies
• Support initiatives related to claims processing and handling
• Verify accuracy of property, equipment, and vehicle inventory lists for renewals
• Use software to organize insurance work
• Record financial discussions with insured members and insurers
• Provide predetermination documentation and schedule pre-approvals
• Act as the main point of contact for internal and external insurance needs
  
  

Required Qualification

• Education: Bachelor's degree in business administration, Insurance, Finance, or related field. Masterâs degree, CLL, LOMA and/or HIA are preferred
• Work Experience: Proven experience (typically 3-5 years) in insurance industry, with at least 1-2 years in managerial role.
  
  

Required Professional Skills.

⢠Strong knowledge of insurance products, policies, and regulations

⢠Excellent leadership and interpersonal skills, with the ability to improve the insurance profile.

⢠Effective communication skills, both verbal and written.

⢠Analytical mindset with proficiency in data analysis and reporting tools.

⢠Detail-oriented and capable of managing multiple priorities in a fast-paced environment.

⢠Proficiency in MS Office Suite and insurance management software

⢠Knowledge of English composition, grammar, spelling, and punctuation

⢠Skilled in the use of Microsoft and computer software (MS Excel, Access, Word, PowerPoint, Application, Pivot Chart⦠etc.) and standard office equipment

⢠Ability to maintain composure and professionalism when exposed to stressful situations

⢠Good knowledge of insurance principles and practices

⢠Ability to engender trust from the insurers, TPA team, co-workers, and insured members

⢠Ability to work cooperatively with management, staff, and suppliers

⢠Ability to prioritize, organize and complete tasks in a timely and independent manner

⢠Ability to accept constructive criticism

⢠Ability to understand and follow written and verbal instructions

⢠Ability to collect data, establish facts, draw valid conclusions, and maintain confidentiality and credibility

⢠Ability to communicate and express thoughts and ideas competently

⢠Ability to quickly grasp relevant concepts regarding duties and responsibilities

⢠Has a positive attitude about the practice, services and solutions provided

⢠Increases knowledge and skills through self-study

⢠Exposure to hectic, fast-paced, high-anxiety environments

⢠Has dependable job attendance and can be relied on the follow through with assigned tasks