Senior Claims Analyst
Qualified candidates, please attach resume when applying.
Our client is looking for a senior claims analyst for their NYC office. The Claims Specialist is responsible for all aspects of Healthcare Professional and General Liability claims, including coverage review, insured contact, investigation, indemnity and expense reserving, litigation management, settlement negotiation, trial observation, payment review and processing, and file documentation.
Manages all aspects of a claim liability (or potential claim) in a pro-active, cost efficient manner until the matter is fully resolved.
Interacts professionally with all (underwriters, risk management, insured contacts, attorneys, and other team members) to promote the success of the Line of Business.
Communicate to management in a timely and accurate manner on all relevant claims issues, including strategy and analysis on reserves and all significant case developments.
Assists in department projects or initiatives as directed.
Effectively utilizes and manages ALAE expenses as needed by outside counsel and consultants.
Keeps abreast of pertinent changes in the case laws, statutes, or regulations relative to surety claims handling.
Maintains necessary industry licensing and education requirements.
Travels as required (court-ordered appearances, account visits, trial reporting, etc).
Qualifications and Requirements:
- Ability to thoroughly review policies, medical records, contracts, etc., as necessary, to complete the handling of claims.
- Ability to discuss handling of claims caseload.
- Ability to document all claims and account handling efforts, including communications with all parties in writing and by phone.
- Ability to make independent decisions according to rules, regulations, and procedures.
- Ability to effectively and independently manage workload while exhibiting sound judgment.
- Clear understanding of Department of Insurance regulations.
- Ability to handle claims in accordance with regulations.
- Clear understanding of the processes and procedures required to be performed to complete the job.
- Ability to communicate effectively at all levels within and outside the company.
- Ability to maintain confidentiality of company-sensitive data.
- Excellent written and oral communication skills.
- Ability to organize, interpret, and apply data/information from a variety of sources.
- Accurate and detail oriented.
- Goal and results oriented.
- Teamwork orientated.
- Ability to work as a member of a team; strong interpersonal skills.
- Strong analytical skills.
- Strong comprehension skills and the ability to follow direction.
- Bachelor’s degree required. Post-graduate degree / certification preferred.