Position Summary:

Responsible for complete secretarial support for the Vice President of Claims and Insurance Operations Support Manager. Schedules, coordinates and records minutes for department and committee meetings. Provides customer service, sets up new claims, and makes assignments to Claims Representatives. Serves as Event Coordinator for the annual Defense Counsel Seminar.

Reporting Relationship:

Reports directly to the Insurance Operations Support Manager; may also take direction from the Vice President of Claims, Regional Claims Manager, Insurance Operations Support Assistant Manager and/or the Chief Operating Officer.

Essential Functions/Responsibilities:

• Works in a cooperative manner with management, coworkers, customers, and vendors; seeks to support  LAMMICO’s mission and vision in daily operations
• Meets assigned target dates and objectives; helps ensure that department quality, service, and productivity standards are met
• Provides claims customer service to insured physicians, other health care providers and third parties including but not limited to, setting up and assigning new claims and confirming coverage in the core operating claims subsystem (OASIS) and resolving physician qualification issues with the Patient’s Compensation Fund (PCF)
• Reviews petitions filed by plaintiff and appropriately codes initial claim information into OASIS
• Maintains agenda for all department meetings and sets appointments on all staff calendars for CC Meetings, Initial Reviews, and departmental meetings; prepares and distributes minutes from CC meetings as well as all departmental meetings
• Serves as backup to Remote Administrative Assistants in maintaining agendas for Initial Review and CC meetings, maintaining records of all x-rays as needed for CC reviews, distributes x-rays to CC members and returns to appropriate individuals when reviews are complete
• Prepares End of Year Comparison Data of CC Members to management yearly
• Provides backup duties to Claims Administrative Assistants in Remote office
• Notifies Claims Representatives of Louisiana State Medical Board of Examiners actions against healthcare provider licenses
• Processes all indemnity and expense checks as received from Finance, sending to requested recipient and printing into ImageRight claim file with file note of delivery method; responsible for documentation of all delivery receipts
• Responsible for all department scanning projects and processing all work in the Unidentified Mail indexing step and Invoice Approval workflow to include all PCF packet unidentified mail
• Responsible for scanning and assuring processing of all Claims Committee Physician expenses and all staff expense reports
• Handles weekly processing of FedEx invoices for payments as well as being backup for monthly Lexis Nexis invoices
• Updates and distributes departmental Business Continuity documents, as needed
• Provides backup duties to Claim Representative Assistant to include completion of all administrative processes involved in the daily processing or closing of a claim
• Responsible for scanning and handling all correspondence and bills on coverage claims handled by the Vice President of Claims
• Responsible for all incidents/claims reported to NAS involving MedDefense coverage; provides NAS with information necessary to determine coverage and process claims
• Event Coordinator working with Regional Claims Manager to coordinate LAMMICO Annual Defense Counsel seminar to include 200 participants and related departmental meetings including interacting with the appropriate liaison at the seminar site, prepares the online registration site and establishes deadline dates, coordinates mailings to attendees, obtains speaker presentations and coordinates presentations for electronic seminar booklet, prepares meeting agendas and handouts, orders seminar materials, produces name badges, coordinates registration, travel and accommodations for seminar attendees and speakers, and summarizes evaluations for management review. Completes applications for CEU and CLE credits for all applicable states, preparing the necessary forms and Certificates of Completion. Organizes Defense Counsel Welcome Reception and the Claims Committee dinner and attendees. Coordinates with CEO and Divisional VP of Insurance Operations with invited Guests Lists, dinner arrangements, menus, give-a-ways, invitations, and dinner place cards.
• Completes departmental reports to include Board of Director Report, Monthly Reports of Productivity and Capsulate Report for review by Claims Department Staff in connection with Claims Committee Meeting, JRA Report, Trial Calendar, Reinsurance Reports, and any other reports management may request. Serves as a backup to report claims settlements on a monthly basis to CMS.
• Responsible for maintaining Claims Dept. Procedural Manual and all Claims Administrative Assistant/Event Coordinator responsibilities on Claims Confluence sites; serves as Claims Department Confluence Coordinator and serves on company Confluence Team
• Enters settlements into CQUAD Drawer as a database for Claims Representatives for quantum studies
• Assists the Insurance Operations Support Manager with backup support in all Operations Departments as needed, also supports other Claims & Business Development and Sales Administrative Assistants
• Relieves front desk switchboard once a week for lunch and breaks and on various other occasions as needed. Also serve as part of the switchboard telephone hunt group
• Responsible for attending Claim Committee meetings and set up of all equipment, controlling audio and video presentation