Claim Operations Analyst - Eastern Alliance
About The Position
The Claim Operations Analyst supports Eastern Alliance, ProAssurance’s workers’ compensation line of business. The position provides technical support to the Claims Department to deliver high levels of customer service, meet regulatory timeframes and requirements, and support the Company’s revenue, profitability objectives, and business plan. The role requires understanding electronic data interchange (EDI) transactions according to specific jurisdictional guidelines. It is hybrid and reports to the Lancaster, Pennsylvania office 2–4 days per month. The analyst completes claim documents and jurisdiction-specific EDI information, corrects data errors and rejections, enters approved indemnity and expense transactions, and assists claim representatives with wage statements and partial-compensation calculations. The role also responds to inquiries and provides general office support and assistance with special projects. The position requires a high school diploma or GED and at least two years of insurance or related experience. An associate’s degree is preferred; a bachelor’s degree may substitute for insurance experience. The salary range is $16.89–$27.87. Candidates must complete Behavioral and Cognitive assessments before being scheduled for an interview with a hiring manager.
Requirements
- High school diploma or GED.
- At least two years of insurance or related experience; a bachelor’s degree may substitute for insurance experience.
- Proficiency in Microsoft Office applications and ability to learn new computer software applications.
- Ability to analyze and interpret information, request additional information when needed, and make appropriate decisions.
- Attention to detail when processing information, establishing priorities, and meeting deadlines.
- Analytical and problem-solving skills, including the ability to formulate logical and objective conclusions.
- Ability to assess the urgency and importance of situations and take appropriate action.
- Ability to communicate effectively and professionally verbally and in writing with internal and external constituencies, including agency partners, customers, and clients.
- Ability to operate standard office equipment, including copiers and fax machines.
- Ability to maintain confidential information.
Nice To Haves
- Associate’s degree.
Responsibilities
- Complete claim documents accurately and ensure they are mailed according to regulatory requirements and Company procedures.
- Complete information according to state-specific EDI trigger guidelines; analyze data and correct errors or rejections returned by jurisdictions.
- Enter accurate data into the computer system for indemnity and expense transactions as approved and directed by the claims representative.
- Assist claim representatives by accurately completing wage statements and calculating partial compensation.
- Respond professionally, courteously, and promptly to telephone inquiries from agents, customers, injured workers, and providers.
- Participate in department meetings as needed and provide general office support, including copying and faxing documents.
- Complete other special projects as assigned.
Benefits
- Access to a best-in-class benefits program.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
