Operations Support Specialist

Job Description:
The Operations Support Specialist is responsible for

designing, developing, coordinating and implementing

automated and non-automated solutions that resolve

operational problems and maximize the benefits derived

from business opportunities. This position’s

responsibilities include developing, designing,

maintaining, monitoring and implementing EDI-EFT

solutions that comply with regulatory requirements

throughout our operating territory. Incumbent will

develop and implement solutions that will maximize

efficiencies to support the Claims Division. Additional

responsibilities include accurately managing

inbound/outbound transactions, and conducting audits and

networking with internal and external partners.

QUALIFICATIONS:

• Bachelor’s Degree, or equivalent work experience

required

• Continuing education in insurance related courses

preferred

• Minimum of 3-years’ experience in a claims technical

or analytical role, with property / casualty

insurance experience preferred

• Demonstrated research and problem-solving skills
• Effective verbal, written and listening

communication skills

• Excellent inter-personal skills that build, maintain

and foster productive relationships to assist in

meeting goals and achieving results, with the

ability to effectively direct and coordinate the

activities of others within a designated project or

team.

• Excellent training and presentation skills
• Proficiency with personal computers, spreadsheets,

Microsoft Office products and database software

required

• Working knowledge of the ImageRight and CWS systems

is preferred

• Medical Bill EDI processing knowledge is preferred
• Demonstrated knowledge of insurance industry claims

systems and claims technology, with knowledge of

EDI-EFT specific technology and methodology

preferred

• Effective customer service skills, with the ability

to meet customer initiated deadlines

• Must possess effective negotiation skills, with the

ability to tactfully explain and defend decisions

while maintaining and promoting positive business

relationships

• Effective decision making and critical-thinking

skills

• Must be able to successfully manage tasks and

projects with aggressive deadlines and time

sensitivity

• Demonstrated ability to interpret and apply standard

practices, procedures and other established business

principles and guidelines

• Must have a strong sense of urgency while

maintaining accuracy in work product

• Must be organized and detail oriented, with the

ability to adapt to change

• Must be able to work independently or as part of a

group

• Must be able to travel periodically, with over-night

stays required

• Must be able to maintain acceptable attendance and

adhere to scheduled work hours

Req. Code : 558

Division/Department : Claims

Skills : Claims Handling – > Workers’ Compensation

Offer Relocation : No

Shift/Hours : First Shift (Day)