Claims Operations Analyst
Company Details
Do you want to be part of a dynamic and growing organization that encourages creativity, collaboration, innovation and individual expression? Are you an insurance professional who wants to think “outside the box” in creating products, underwriting and servicing customers? Berkley Healthcare is a dynamic, start-up company that encourages a pioneering mindset with the financial backing of a Fortune 500 company.
As a member company of W. R. Berkley Corporation, Berkley Healthcare has assembled a unique team of multi-disciplinary insurance professionals to take a fresh look at healthcare organization insurance. We pride ourselves on our deep expertise in underwriting, claims and distribution in the healthcare industry insurance market. We understand that the healthcare industry is in a state of rapid evolution; shaped by emerging concepts in technology, law, public welfare and social economics, all with attendant enterprise risk unique to healthcare organizations. We apply cutting-edge insurance concepts to traditional healthcare insurance products. Concepts that embrace the current complexity of the healthcare industry. Concepts that give ultimate flexibility in managing enterprise risk.
Founded in 1967, W. R. Berkley Corporation is an insurance holding company that is among the largest commercial lines writers in the United States and operates worldwide in two segments of the property casualty insurance business: Insurance and Reinsurance. Each of the Berkley companies, or operating units within Berkley, participates in a niche market requiring specialized knowledge about a territory or product.
Our competitive advantage lies in our long-term strategy of decentralized operations, allowing each of our Berkley companies to identify and respond quickly and effectively to changing market conditions and local customer needs. This decentralized structure provides financial accountability and incentives to local management and enables us to attract and retain the highest caliber professionals. We have the expertise and resources to utilize our strengths in the present environment, and the flexibility to anticipate, innovate and respond to whatever opportunities and challenges the future may hold.
Responsibilities
The Claims Operations Analyst is a vital component in the Claims Operations Team and is responsible for supporting Claims Operations across all lines of business. This multifunctional role is involved in a variety of Claims Operations functions, including claims data entry and file set-up, in-depth loss run analysis, and reinsurance reporting activities. The Claims Operations Analyst has a thorough understanding of Claims Operations best practices which are key in supporting the Claims Team in functioning efficiently and effectively. Regular support of the Claims Team with ad hoc requests, questions, and projects may also be involved.
- Analyze and triage incoming claim information to ensure the highest risk claims are prioritized first and act as backup to Claims Technician whenever necessary
- Enter claim data and set-up claim files into the claims system or alternative database, ensuring timeliness
- Timely respond to ad hoc requests and questions from Claims Team
- Communicate effectively and professionally with internal and external customers
- Assist Claims Team in reviewing accounts and analyzing submissions and loss runs for claims with possible exposure to the Company
- Assist in onboarding of new Claims Operations hires
- Identify and communicate unusual/significant observations to Claims Team in a timely fashion
- Prepare quarterly reports for reinsurance reporting and coordinate distribution with Claims Management
- Assist with special projects as assigned to meet the needs of our internal and external users
- Minimal administrative work may be involved; this can include answering phones, receiving deliveries and visitors, managing the postage meter, ordering office supplies, receiving and distributing mail, etc.
- Miscellaneous other duties, such as point-of-contact for building and copier maintenance, may also be involved if this person works from a Company office
Qualifications
- Associate’s degree or equivalent education and work experience
Required:
- Intermediate knowledge of Microsoft Outlook, Word, and Excel
- Working knowledge of medical terminology
Preferred:
- At least 3 years of experience as a claim’s technician, claims triage specialist, claims data entry clerk, medical scribe, medical billing specialist, or equivalent
Skills:
- Ability to meet deadlines while handling multiple, sometimes shifting, priorities
- Ability to effectively communicate with others, both verbally and in writing
- Ability to work independently and in a group setting
- Ability to act as a mentor to junior team members
- Ability to use critical thinking and problem-solving skills