STATE OF NEW HAMPSHIRE
HUMAN RESOURCES


CLASSIFICATION:  CLAIMS PROCESSOR TRAINEE

 

Class Code:  2035-07                                        Date Established:  05-16-78           

 

Occupational Code:  1-2-2                                Date of Last Revision:  12-28-01

 

BASIC PURPOSE:  To screen and check claim forms prepare documents for processing and process claims under direct supervision.

 

CHARACTERISTIC DUTIES AND RESPONSIBILITIES:

 

·        Screens, checks and compares data on claim forms for completeness and accuracy prior to data entry and following a review by supervisor.

 

·        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 following a review with the supervisor.

 

·        Processes vendor claims for payment by calculating payment under supervision.

 

·        Enters claims data into computer system to ensure accurate case record maintenance.

 

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DISTINGUISHING FACTORS:

 

Skill:  Requires skill in applying instructions to accomplish different job functions OR in operating machines for a variety of different purposes.

 

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 minimal choice in performing routine duties under immediate supervision and in following simple instructions according to standardized policies and 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:  One year of experience involving forms or claims examination or similar audit and verification activities.

 

License/Certification:  None required.

 

SPECIAL REQUIREMENTS:  For appointment consideration, Claims Processor Trainee applicants must successfully participate in a written examination measuring possession of knowledge, 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 data processing.  Knowledge of data processing methods and techniques.  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.

 


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Last Updated 05/10/02
URL: /hr/classspec_c/2035.htm