Claim Operations Analyst - Eastern Alliance

ProAssurance Group•Lancaster, PA

3d•Hybrid

About The Position

An exciting opportunity exists to join the ProAssurance family of companies! Our mission is powerful and simple: We protect others. Choosing a place to apply your talents is an important decision for anyone. You have plenty of options. Why choose ProAssurance? At ProAssurance, we sell a pledge, and that pledge is delivered by our team members. We are seeking individuals who value integrity, leadership, relationships, and enthusiasm—and want to build their career with a great company where they can be their authentic self and feel valued, recognized, and rewarded for their contributions. ProAssurance specializes in healthcare professional liability, products liability for medical technology and life sciences, legal professional liability, and workers' compensation insurance. We are an industry-leading specialty insurer, with job opportunities in much of the contiguous United States. This position supports our workers' compensation line of business, Eastern Alliance, and is hybrid, reporting to the Lancaster PA office 2-4 days per month. The primary responsibility of this position is to provide technical support to the Claims Department to deliver superior levels of customer service and ensure the compliance with regulatory timeframes and other requirements in support of the Company’s revenue and profitability objectives and overall business plan. The role also includes the ability to understand EDI transactions according to specific jurisdictional guidelines.

Requirements

High school diploma or GED required with a minimum two years of insurance or related experience is required.
Proficiency in Microsoft Office computer applications; ability to learn new computer software applications.
Analytical ability, to analyze and interpret information; request more information when needed; and make appropriate decisions regarding a course of action.
Attention to detail in processing all information, establishing priorities and meeting deadlines.
Solid analytical and problem-solving skills, including formulating logical and objective conclusions.
Ability to assess the urgency and importance of a situation and take appropriate action.
Ability to communicate effectively and professionally both verbally and in writing with various constituencies and at all levels; both in and outside of the organization including agency partners, outside customers and clients.
Ability to operate standard office equipment including, but not limited to, copiers, fax machines, etc.
Ability to maintain confidential information.

Nice To Haves

An associate’s degree is preferred.
A bachelor’s degree may substitute insurance experience.

Responsibilities

Complete accurate information on claim documents and ensure proper mailing in accordance with regulatory requirements and Company procedures; Complete accurate information according to state specific EDI trigger guidelines.
Analyze data and fix errors/rejections returned from individual jurisdictions.
Enter accurate data into the computer system to make accurate indemnity and expense transactions as approved and directed by the claims representative daily.
Assist Claim Representative through the accurate completion of wage statements and calculation of partial compensation.
Respond to telephone inquiries from agents, customers, injured workers, and providers in a professional, courteous and timely manner, providing high levels of customer service at all times.
Participate in department meetings as needed; provide general office support through copying and faxing documents.
Other special projects as assigned.