Claims Processing Specialist

Summary:We are seeking a detail-oriented Claim Processing Specialist to perform complex and responsible cervical duties related to the claim processing in the home office.

Essential Duties and Responsibilities include the following. Other duties may be assigned. 

• Claim Entry & Processing: Manage claim setup, claim routing, reserves, and adjuster codes within strict deadlines. Complete requested tasks in support of Claim Adjusters. Index incoming mail and send requested letters. 
• Payment & Financial Handling: Process automated and manual drafts, stop payments, voids, and canceled check requests. Process subrogation, salvage, and credit transmittals, updating system amounts and forwarding checks to Accounting.
• Tax & System Maintenance: Maintain Tax ID numbers and addresses for vendors, body shops, medical facilities, and attorneys. Issue and mail annual 1099 forms.
• Communication & Support: Answer incoming claims calls and assist call center staff, agents, adjusters, and insureds with inquiries.
• Administrative & Special Projects: Compile data and complete special projects as assigned.

Qualifications

Education, Work Experience, and Certifications

• High school graduate or equivalent. Three years or more claim clerical experience is preferred.

Required Knowledge and Skills:

• Communication: Excellent verbal and written communication skills; able to explain complex information clearly and handle sensitive interactions with professionalism and empathy.
• Technical: Proficient in computer systems, data entry, and claims software; strong organizational, time management, and multitasking abilities.
• Analytical: Ability to interpret policy language, legal principles, and medical documentation accurately.
• Decision-Making: Strong problem-solving and judgment skills; comfortable interpreting contracts and applying company policy.
• Mathematical: Competent in basic math concepts for accurate claim calculations.
• Reliability: Consistent attendance, punctuality, and accountability

Special Relationships (relationships with other people, internally and externally, cost control, etc.): Frequent and professional communication with agents, insureds, claimants, attorneys, physicians, and other service organizations via the phone and in person. Works efficiently under normal supervision while remaining fully accountable for all results.  Communicates effectively with upset or angry individuals, constructively resolving disputes and disagreements. Maintains strong awareness as a company representative, projecting a positive image in every interaction.

Physical Requirements: 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 occasionally required to stand, walk, sit, use hands to finger, handle, or feel, reach with hands and arms, climb or balance; stoop, kneel, crouch, or crawl; and talk or hear. The employee  may occasionally lift and/or move up to 25 pounds. The noise level in the work environment is usually moderate.

Nodak Insurance Company complies fully with all federal, state, and local employment laws and shall provide equal employment and advancement opportunities for all persons regardless of race, color, creed, religion, national origin, sex, sexual orientation, age, the presence of any mental or physical disability, status with regard to public assistance or marriage, or any other category protected by local, state, or federal law.