STATE OF NEW HAMPSHIRE
HUMAN RESOURCES
CLASSIFICATION: CLAIMS PROCESSOR I
Class Code: 2032-09
Date Established: 03-20-73
Occupational Code: 1-2-2
Date of Last Revision: 12-28-01
BASIC PURPOSE: To screen and check claims forms,
prepare documents for processing and process claims.
CHARACTERISTIC DUTIES AND RESPONSIBILITIES:
·
Screens, checks and
compares data on claims forms for completeness and accuracy prior to data
entry.
·
Processes corrections
and adjustments based upon computer generated transaction and error listings.
·
Processes updated
information on case records to maintain computer master file.
·
Retrieves rejected
claims information for computer system for transmittal to proper area of
disposition.
·
Processes vendor
claims for payment by calculating payment amount.
·
Enters claims data
into computer system to ensure accurate case record maintenance.
-------------------------------------------------------------------------------------------------------------------------------------------
DISTINGUISHING FACTORS:
Skill: Requires skill in recommending routine
changes in standardized operating procedures OR in retrieving, compiling and
reporting data according to established procedures OR in operating complex
machines.
Knowledge: Requires understanding and using
business or trades vocabulary or basic arithmetic to perform standard operating
procedures.
Impact: Requires responsibility for
contributing to agency objectives by ensuring the accuracy of support
activities within one or more organizational units. Errors at this level affect the work of others or have
measurable monetary consequences, and require verification and correction in
order to complete succeeding work operations.
Supervision: Requires no supervision of employees or
functions.
Working Conditions: Requires performing regular job
functions under good conditions in a safe working environment.
Physical Demands: Requires sedentary work, including
continuous sitting or occasional standing and walking.
Communication: Requires explaining facts, interpreting
situations, or advising individuals of alternative or appropriate courses of
action. This level also requires
interviewing or eliciting information from state employees or members of the
general public.
Complexity: Requires a combination of job functions
using minimal judgment to perform a variety of job tasks according to clearly
prescribed standard practices and procedures.
Independent Action: Requires making a limited number of
choices in selecting among alternative courses of action under supervisory
guidance and in performing job functions according to a variety of prescribed
policies or procedures.
MINIMUM QUALIFICATIONS:
Education: High school diploma, G.E.D. or its
equivalent. Each additional year
of approved formal education may be substituted for one year of required work
experience.
Experience: Two years' experience involving forms
or claims examination or similar audit and verification activities
License/Certification: None required.
SPECIAL REQUIREMENTS:
For appointment
consideration, Claims Processor I requires that applicants successfully
participate in a written examination measuring possession of knowledge(s),
skills and abilities identified as necessary for satisfactory job performance
by this class specification.
RECOMMENDED WORK TRAITS: Knowledge of the basic theories and
principles of auditing. Skill in
making simple mathematical computations with speed and accuracy. Ability to refer to code listing and
make proper code entries on forms.
Ability to follow instructions.
Ability to establish and maintain harmonious working relationships with
other state agencies and employees.
Must be willing to maintain appearance appropriate to assigned duties
and responsibilities as determined by the agency appointing authority.
DISCLAIMER STATEMENT: This class specification is descriptive
of general duties and is not intended to list every specific function of this
class title.
Back to Human Resources Home Page
Back
to State Opportunities Listing Page
Back to Class Specification List
Last Updated 05/10/02
URL: /hr/classspec_c/2032.htm