Associate Claims Analyst

OMS NATIONAL INSURANCE CO•Schaumburg, IL

3d•$58,000 - $70,000•Hybrid

About The Position

The Associate Claims Analyst works within the Claims department, responding to insureds after an incident is reported and providing timely, clear communication about potential claims. The role investigates, evaluates, and resolves claims, with a primary focus on pre-litigation claims. The analyst communicates with insureds, claimants, and attorneys; reviews medical and dental records; documents claim files; evaluates coverage, liability, causation, and damages; and supports claims through resolution. The role also assists insureds with inquiries before or instead of formal claim handling, prepares case summaries for committee meetings, sets reserves, and may prepare settlement authority requests and conduct settlement negotiations. The position is performed in an office environment, with a hybrid opportunity at the manager’s discretion.

Requirements

Bachelor’s degree required; equivalent demonstrated professional experience may be considered.
Proven relationship management expertise.
Working understanding of medical records.
Proficiency with Microsoft Office Suite, with emphasis on Word, Excel, and PowerPoint.
Ability to productively interact with policyholders, legal professionals, external vendors, management, and board members.
Effective written and oral communication skills, including communicating clearly and concisely with varied stakeholders.
Ability to multitask in a fast-paced environment.
Strong critical-thinking and problem-solving skills.
Ability to assert a position while communicating with empathy.
Effective analytical skills to gather information, analyze facts, and make recommendations.
Ability to prepare robust reporting and provide broad-scope overviews and summaries.
Strong negotiation skills.

Nice To Haves

1–2 years’ experience in the legal, insurance, medical, or claims management field is preferred; educational background may be considered in lieu of related work experience.

Responsibilities

Conduct claim investigations, including assessing policy coverage and evaluating liability, causation, and damages, to move claims toward resolution.
Communicate with insureds, claimants, and attorneys, including providing timely updates on claim status and resolution.
Assist insureds with inquiries prior to or in lieu of formal claim handling.
Maintain timely and accurate claim file documentation.
Review medical and dental records and supporting documentation to evaluate claims.
Prepare case summaries and present claims for committee meetings.
Set timely and reasonable indemnity and expense reserves.
Prepare settlement authority requests and conduct settlement negotiations when appropriate.