Question

1- write down ways you could try using staffing activities to achieve equally effective matches for new job applicants. For example, for the medical claims adjuster job, you might develop a special recruitment advertisement explaining the exact claims knowledge needed, develop a knowledge test to be used as part of the selection process, and have a higher starting pay for the most knowledgeable applicants to whom you make employment offers.

a) Next, think of a time on your current job or a past job when you were extremely satisfied with the job, when you felt “it doesn’t get much better than this.” Using the person-job match model, identify and record specific examples of effective matches between your own needs and job rewards that seemed responsible for this satisfaction. For example, on the medical claims adjuster job, perhaps you received a formal letter of recognition from your boss for having the lowest error rate among all adjusters for the past six months.

b)Now that you have identified examples of an effective person/job match, identify and record ways you could try using staffing activities to achieve equally effective matches for new job applicants. For example, for the medical claims adjuster job, perhaps you could feature an employee recognition program in recruitment brochures, ask applicants interview questions about previous recognition they have received and how they felt, and provide a job offer to applicants that guaranteed they would attend an extensive training program on reimbursement procedures during their first six months on the job.

Answer 1

Recruitment Advertisement format: Job description

"XYZ medical insurance having an excellent track record of settling claims in record times is looking for brilliant minds who believe in making things happen rather than working to make things happen,who believe in making more money than their base salaries month on month...If you are in for this...do apply today"

Medical Claims Specialist Examiner Job Responsibilities:

Serves medical insurance customers by determining insurance coverage; examining and resolving medical claims; documenting actions; maintaining quality customer services; ensuring legal compliance.

Medical Claims Specialist Examiner Job Duties:

• Determines covered medical insurance losses by studying provisions of policy or certificate.
• Establishes proof of loss by studying medical documentation; assembling additional information as required from outside sources, including claimant, physician, employer, hospital, and other insurance companies; initiating or conducting investigation of questionable claims.
• Documents medical claims actions by completing forms, reports, logs, and records.
• Resolves medical claims by approving or denying documentation; calculating benefit due; initiating payment or composing denial letter.
• Ensures legal compliance by following company policies, procedures, guidelines, as well as state and federal insurance regulations.
• Maintains quality customer services by following customer service practices; responding to customer inquiries.
• Provides legal support by assembling documentation for settlement action.
• Protects operations by keeping claims information confidential.
• Prepares reports by collecting, analyzing, and summarizing information.
• Updates job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations.
• Accomplishes organization goals by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments.

Medical Claims Specialist Examiner Skills and Qualifications:

Claims Adjustment, Financial Software, Documentation Skills, Data Entry Skills, Analyzing Information , Problem Solving, Verbal Communication, Customer Focus, FDA Health Regulations, General Math Skills, Statistical Analysis