Claims Analyst II

Towne Park•Plymouth Meeting, PA

1d•$62,000 - $68,000•Onsite

About The Position

The Claims Analyst II will perform a range of functions around the claims oversight and administration work in the receipt, review, and processing of claims received by Towne. This position will provide assistance to Towne’s field personnel, and assistance for some external customers, and to other workers in Towne’s Claims Dept, and for the outside claims TPAs, as assigned.

Requirements

High school diploma or general education degree (GED).
Six to twelve months (or more) insurance claims related experience.
Strong understanding of insurance claims processes and procedures.
An interest and willingness to learn about claims and litigation topics that pertain to the company and the dept.
Understanding of self-funding, self-insured retentions, and third-party administrating (TPA) concepts.
Computer proficiency and technical aptitude with an ability to utilize advanced functions of MS Office (Excel, Word, and Outlook), the internet and various internal and external Claims applications and databases.
Excellent verbal and written communication skills, and the ability to communicate effectively with internal Towne personnel and external customers, vendors, business partners, and attorneys.
Ability to work independently to effectively prioritize and plan work activities, and using time efficiently and developing realistic action plans to accomplish required tasks.
Ability to manage several projects simultaneously while working under pressure to meet deadlines.
The individual identifies and resolves problems in a timely manner and gathers and analyzes information skillfully.
Ability to exercise good judgment and discretion in the processing and documenting of claim files.
Ability to read, analyze, and interpret general business correspondence, instruction guides, and training materials.
Ability to speak clearly and persuasively in positive or negative situations, and have group presentation skills, and participates in meetings.
Ability to read and interpret documents and procedure manuals.
Ability to write routine correspondence.
Ability to add, subtract, multiply, and divide.
Ability to define problems, and collect data, establish facts, and draw valid conclusions.
Ability to interpret an extensive variety of instructions in written or diagram formats.

Nice To Haves

Some college preferred.

Responsibilities

Reviews claims documentation, including estimates and expense bills/invoices that are received from various sources pertaining to claim files.
Analyzes, reviews, and oversees claims within designated dollar thresholds, and consults with the Claims Manager or others in the dept for assistance as needed.
Communicates with Towne’s field personnel, and with other internal Towne staff, and with the claims TPAs and outside lawyers, and insurance companies, and other vendors, as needed.
Acts as liaison between corporate and field offices to coordinate the gathering of information that will facilitate proper responses to the claims TPAs and defense counsel.
Handles inquiries and requests from outside attorneys, insurance companies, and individuals in connection with any claim files or other matters that the Claims Dept needs to deal with.
Handle incoming phone calls and incoming emails.
Comply with all State and federal laws, and all company policies and procedures.
Assists inside and outside people and entities with questions and various inquiries regarding claims and/or payments.
Assists with rental car assignments.
Sets up new claim files in the Towne systems, when requested.
Documenting of claim files in the internal Towne system(s).
Dealing with collections and subrogation matters, which sometimes involves Arb Forums intercompany arbitration.
Initiate necessary correspondence for demand of reimbursement, and respond to incoming demands for reimbursement from subrogating entities.
Transmit documents and other items to the claims TPAs that are utilized by Towne.
Responding to the frequent requests for information, status, and updates from Towne field personnel.
Works independently and sometimes in a group, to handle and complete special projects, as assigned.
Partners with Claims Manager and Claims Director to provide support for various claims, including some claims in litigation.
Provides claims TPAs with settlement authority up to $25,000.
Partners with Claims Manager and Claims Director on projects and development of procedural and process documentation.