Claims Assistant

Basic Function

In support of meeting the department’s goals and objectives the Claims Assistant is responsible for providing administrative support to the Claims department.  Performs duties in a safe, efficient manner and in compliance with all applicable rules and safety procedures.

Responsibilities and Specific Duties

• Provides administrative support to the Claims department.
• Responds to incoming calls from the public, claimants, insurance companies, attorneys, medical providers, and METRO personnel. 
• Creates and assigns new claims in the claims database based on information from emails, reports, letters, and other documents.
• Opens, sorts, and distributes mail from claimants, insurance companies, attorneys, and medical providers. 
• Manages the department email folder to ensure that emails are distributed to adjusters and documents are attached to claim records when appropriate.
• Where appropriate, uploads faxes, letters, and other documents into the electronic claim file database.
• Acts as the Coordinator of Records and complies with the Records Management Policy and Guidelines regarding files, archives, retrieval, and disposal of closed claim files.
• Keeps all historical paper records and internal department drives organized and cataloged per METRO’s data retention policy.  
• Processes daily medical bill batches segregating them were appropriate. Verifies vendor entry into the claims database and retrieves W9 tax forms for vendor payments. IRS certification must be obtained within 30 days of employment. 
• Inputs recovery and refund checks for Liability and Workers Compensation, into the claims data base. Maintains an account of recoveries for review by management and accounting. 
• Delivers checks with appropriate documentation to Treasury and Accounting.  
• Enters and updates vendor information into the AP database. Compiles, prepares, maintains, and monitors various reports on a daily, monthly, quarterly, and yearly basis when requested.  Prepares other documents and/or generates reports as requested by management.
• Compiles and prepares timely reports or responsive documents required by the Texas Department of Insurance, Division of Workers Compensation (TDI/DWC), METRO Legal Department and the Medical or Bill Auditing Company.
• May schedule return to work physicals and referrals of employees for drug screenings. May prepare/mail DWC & PLN forms for the adjusters.
• Supports claims adjusters by completing work requests, notarizing documents, preparing subrogation demand letters for registered mail, copying files for referral to litigation, and assisting bilingual claimants for recorded statements.
• Completes bus video retrieval requests.  Retrieves pertinent sections of video, forwards to adjuster, catalog, and maintain records. 
• Consults with adjusters and/or Supervisor as warranted.
• Provides excellent customer service to METRO internal and external customers.
• Applies SMS (Safety Management System) methods and principles in daily routine and supports all aspects of the agency’s Public Transportation Agency Safety Plan (PTASP).
• Promotes safety awareness and follows safety procedures to reduce or eliminate accidents.
• Performs other job-related duties as assigned.

 Pay Range:  $40,100 - $51,600

Education Requirement

High school diploma or GED is required.

Years & Experience Required

Minimum of four (4) years general office experience preferably in an insurance claims environment or legal office.  Experience with workers compensation, liability or litigation claims litigation preferred.  Bilingual preferred.

Knowledge & Skills Required

Excellent customer service skills.  Bilingual skills to assist with interpretation preferred.  Working knowledge of PC’s and related software; Microsoft Office, Excel, Teams, PowerPoint.  Must have high attention to detail while operating bus video reviews.  Must be organized with excellent time management skills.  Knowledge of or experience with Texas Tort Claims Act.  Notary in the State of Texas preferred. Must be able to type 35 words per minute, and a typing test is required. Texas All Lines or Workers’ Compensation Adjuster license preferred. Strong writing skills required.

Additional Information

The Metropolitan Transit Authority of Harris County, Texas has a zero tolerance drug and alcohol policy for all employees. All internal and external applicants will be required to undergo drug testing before employment and will be subject to further drug and/or alcohol testing throughout their employment.

Further, employees who perform safety-sensitive functions will submit to drug and/or alcohol testing in accordance to the Department of Transportation (DOT) and the Federal Transit Administration (FTA) regulatory requirements.

We provide equal opportunity to all qualified individuals regardless of race, color, religion, age, sex, national origin, veteran status, genetic information or disability.