What are the responsibilities and job description for the Claims Examiner position at NEW JERSEY HOSPITAL ASSOCIATION GROUP?
Job Details
Description
The New Jersey Hospital Association is a not-for-profit trade organization committed to delivering support and services to the states hospitals, health systems and other healthcare providers. We share a collective goal of providing quality, affordable and accessible healthcare to the people of the Garden State. We are seeking a Claims Examiner.
Objective: Reviews routine unemployment insurance claims. Also reviews complex claims with input from senior PCM staff. In disputed claims conducts investigation and with input from senior staff determines if appeal is warranted and follows through on appeals process.
Essential Job Functions:
- Reviews initial monetary and non-monetary determinations to confirm that such determinations are consistent with information submitted by client and are appropriate with respect to state and federal statutes.
- Based on information received from Division of Unemployment Insurance and from employer, advises employer whether or not appeal is warranted. If appeal is filed, follows through with the appeals process.
- Establishes and maintains claim records to include posting and auditing charges and initiating protests on those charges to be in error.
- Reviews penalties issued against clients based on review requests, cancellation, abatement or advises client to pay.
- Provides NJ Department of Labor with wage and separation information on claims for clients for whom PCM is the addressee of record.
- Contacts employer by letter, email, phone, fax, requesting wage and/or separation information.
- Upon receipt of information, completes necessary unemployment form(s) and forwards to appropriate Local Unemployment Office.
- Maintains electronic log of incoming UI forms to ensure timeliness guidelines are met.
- Maintains check-up files to track responses from employers and NJ Dept. of Labor.
- Abides by the terms and conditions of the Confidentiality & Non-Disclosure Agreement.
Non-Essential Job Functions:
- Testifies at hearings when necessary to establish the timeliness of an appeal.
- Assumes additional responsibilities.
Qualifications
Qualifications: High school graduate. Good communication skills. Individual should not pose a threat to the health or safety of self or others.
NJHA offers a competitive salary and a comprehensive benefits package including no-deductible medical insurance, dental, flexible spending accounts, 401(k) with employer match, pension plan, (state) short term disability, long term disability, life, employee assistance program, credit union, and generous paid vacation, holiday, and personal, and sick days.
NJHA is an equal opportunity employer and does not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, genetic information, marital status, amnesty, status as a veteran, or any other category protected by federal, state, and local laws.