Claims Analyst I Jobs

SUMMARY

The Claims Analyst I will perform a range of professional claims adjusting and administration work in the receipt, review, and processing of claims and payments regarding damage to customer property. This position will provide assistance to customers and administrative staff and partner with the Regional Red Alert Claims Analyst as assigned.

ESSENTIAL FUNCTIONS

Reasonable accommodations may be made to enable individuals with disabilities to perform all functions.

Descriptive Statement(s)

• Reviews claims estimates loss and expense costs that are received from claimants or third parties. Analyzes, reviews, and adjusts claims for non-Red Alert sites within assigned region as well as Red Alert claims valued at less than $2,500 for accuracy, completeness and eligibility, consults with Claims Manager or peers for assistance as needed.

• Communicates with Account Managers, District Manager, and Vice Presidents for any adjustment of a claim. Communicates with claimants, insurance companies and or any other parties involved with the claim.

• Acts as liaison between corporate and field offices to coordinate the gathering of information that will facilitate proper response to claim losses and legal documents. Acts as the liaison to attorneys, insurance companies and individuals investigating any incidents that may result in asset loss

• Comply with state laws, policy and company procedures. Assists claimants, providers, and clients with problems or questions regarding their claims and/or policies. Handles rental subrogation claims and negotiates settlements to reducing claims costs. Examines claim forms, police reports and damage reports to initiate the claims process. Sets up files; when necessary, assigns claim numbers and logs in claims; collects and distributes supporting documents as required. Processes new claims and disseminates the claim if necessary to the insurance carrier

• Maintains records and cross reference tickler files for processing collections and or subrogation; initiates necessary correspondence for demand of payment or explanation of actions. Processes claim payments; maintains record of accounts; partners with Red Alert Claims Analyst when trends are identified; prepares recommendations, correspondence and backup information to support. Monitors and adjusts records in computerized information system for daily status; reviews accounts and prepares various monthly and annual reports.

• Drafts written responses or replies by phone or e-mail when necessary. Responds to regularly occurring requests for information. Works independently and within a team on special nonrecurring and ongoing projects.

• Types and designs general correspondences, memos, charts, tables, graphs, business plans, etc. Proofreads copy for spelling, grammar, and layout, making appropriate changes. Responsible for accuracy and clarity of final copy.

• Partners with Claims Manager providing support for pending claims in litigation. Settlement Authority level up to $10,000. Partners with claims manager on projects and development of procedural and process documentation.

QUALIFICATIONS

Education:

• High school diploma or general education degree (GED)

Work Experience:

• Six to twelve months related experience and/or training; or equivalent combination of education and experience.

Knowledge:

• Strong understanding of claims analyst process and procedures.
• Understanding of Self-Funding and Third Party Administrating concepts.

Skills:

• Excellent written communications skills to provide any necessary correspondence with internal and external customers.
• Ability to read and interpret documents, insurance claims and procedure manuals. Ability to write routine correspondence.
• Ability to exercise judgment and discretion in the adjustment of a claim.
• Ability to manage several projects simultaneously while working under pressure to meet deadlines.
• Ability to work independently to effectively prioritize and plan work activities, uses time efficiently and develops realistic action plans to accomplish required tasks.
• Excellent verbal communication skills to speak clearly and persuasively in positive or negative situations, demonstrates group presentation skills and participates in meetings.
• Computer proficiency and technical aptitude with an ability to utilize advanced functions of MS Office (Excel, Word, and Outlook), the internet and various Claims applications and databases.
• Ability to add, subtracts, multiply and divides.
• Ability to define problems collects data, establish facts, and draw valid conclusions.
• Ability to read, analyze and interpret general business correspondence, instruction guides, and training materials.
• Ability to interpret an extensive variety of instruction in written or diagram form.
• The individual identifies and resolves problems in a timely manner and gathers and analyzes information skillfully.

SCOPE

Authority to Act:

Job is fairly routine. Incumbent follows established practices and procedures. Duties are performed with specific directions given and work is checked or verified on a frequent basis. Decisions are made within specific operational instructions and departmental guidelines. Errors in judgment could affect the smooth and efficient operation of the department.

Budget Responsibility:

The employee has control over resources available only.

WORKING CONDITIONS & PHYSICAL DEMANDS

The working conditions and physical demands described here are representative of those that must be met by an associate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Physical Requirements

While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to sit or stand for extended periods of time and may be required to run; walk; handle or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

Lifting Requirements

Exerting up to 50 pounds of force occasionally, and/or up to 25 pounds of force frequently, and/or greater than 10 pounds of force constantly to move objects.

Working Environment

The majority of work will be performed in climate-controlled environment, but may be exposed to inclement weather and varying degrees of temperatures on occasion.

Travel

Travel of up to 5% may be required.