Claim Operations Analyst - Eastern Alliance

ProAssurance Group • Lancaster, PA

9d • Hybrid

About The Position

The Claim Operations Analyst provides technical support to the Claims Department for Eastern Alliance, ProAssurance’s workers’ compensation line of business. The position helps deliver superior customer service, meet regulatory timeframes and requirements, and support the Company’s revenue, profitability, and business plan. It also requires understanding electronic data interchange (EDI) transactions under jurisdiction-specific guidelines. The position is hybrid and reports to the Lancaster, Pennsylvania office 2–4 days per month.

The analyst processes claim documents and jurisdiction-specific EDI information, enters approved indemnity and expense transactions, assists with wage statements and partial-compensation calculations, and responds to inquiries. The role also provides general office support and works on special projects as assigned.

Requirements

• High school diploma or GED.
• At least two years of insurance or related experience, unless substituted by a bachelor’s degree.
• Proficiency in Microsoft Office applications and ability to learn new software applications.
• Analytical ability to interpret information, request additional information when needed, and make appropriate decisions.
• Attention to detail when processing information, setting priorities, and meeting deadlines.
• Solid analytical and problem-solving skills, including the ability to formulate logical and objective conclusions.
• Ability to assess the urgency and importance of a situation and take appropriate action.
• Effective and professional verbal and written communication with people at all levels, both inside and outside the organization, 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 accurate information on claim documents and ensure proper mailing in accordance with regulatory requirements and Company procedures.
• Complete information according to state-specific EDI trigger guidelines; analyze data and correct errors or rejections returned by individual jurisdictions.
• Enter accurate data into the computer system for indemnity and expense transactions 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED