Claims Processing Specialist

Full Time
Atlanta, GA
Posted
Job description

Benefits: (Funded by employee premiums and employer contributions)

  • Health and Flexible Benefits Available
  • 13 paid state holidays
  • Annual & Sick Leave
  • Hybrid/Remote Work Environment

Criminal Justice Coordinating Council (CJCC) is administratively attached to GBI. CJCC is legislatively charged with eleven areas of criminal justice coordination. Among those responsibilities is to serve as the statewide

clearinghouse for criminal justice information & research; Develop criminal justice legislative & executive policy

proposals; & serve in an advisory capacity to the Governor on issues impacting the criminal justice system. CJCC plans & administers tens millions of dollars in federal criminal justice and victim services grants. This position is located at Criminal Justice Coordinating Council 104 Marietta Street, NW, Atlanta, Georgia


Applicants chosen for employment will be subject to financial, driving, education and criminal background and reference checks. Work eligibility will be checked in EVerify. As a federally funded agency, CJCC is subject to federal Drug Free Workplace requirements. CJCC is an equal opportunity employer.


Under direct supervision, reviews, evaluates, and processes claims or related transactions claimants & victims of violent crimes (e.g., Sexual Assault, Domestic Violence, Homicide), using applicable laws, rules and program regulations to determine basic compensability, liability, or eligibility for reimbursement or to process predetermined monetary claims. Prepares documents initiating payment or settlement of claims, complies reports and program documentation, and responds to customers or claimants

Key Duties & Responsibilities


Assembles data and makes computations within established guidelines

Categorizes expenditures and maintains appropriate files

Gathers and compiles data and prepares reports

Monitors claims and payments to ensure timely processing and compliance with rules and regulations

Performs work relating to ensure timely processing and compliance with rules and regulations

Performs work relating to the examination and approval/denial of claims

Prepares documents initiating payment or settlement of approved claims

Processes and maintains applications and records and reconciles accounts related to claims

Provides assistance with the resolution of claim/settlement disputes

Records financial transactions to expenditure documents, journals, ledgers and/or automated accounting systems

Responds to requests from clients regarding filing requirements, returned/denied claims, program eligibility and/or interpretation of federal and state laws

Tracks/monitors payments and related activity


Entry Qualifications

Associates degree from an accredited college or university OR High School diploma or GED AND

One year of job-related experience


Preferred Qualifications

Entry Qualifications AND

Proven customer service phone interaction High level of computer proficiency Experience in claims processing and/or Knowledge of medical terminology and/or

Experience in assessing claimant documentation of violent crimes and/or

Certification in medical coding, health information technology and/or another closely related field


NOTE: The above job description represents the general nature, primary duties and responsibilities, and qualifications for the work performed by employees within this job, but it is not a comprehensive and exhaustive list. Employees may be required to perform other duties a assigned, and specific duties, responsibilities and activities within the core nature of the job may change at any time with or without notice. Employees must be able to perform the essential functions of the job, as specified by the employing entity with or without reasonable accommodation.


Only applicants selected for interview will be notified for applicant selection. Human Resources maintains the discretion to close the job announcement prior to the closing date if a significant number of applications are received.

If an accommodation is needed for any part of the employment process, please contact Human Resources Office at (404) 657-1972

Associate's degree from an accredited college or university OR High school diploma or GED AND One year of job related experience.

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