Claims Analyst

Allied Solutions • Batavia, IL

277d

About The Position

The Claims Analyst position will handle claims of greater complexity and will require a higher level of investigation, negotiation, evaluation, disposition and settlement of complex/specialty claims and large loss exposure. Ideal candidates should possess a strong attention to detail and a passion for providing excellent customer service to both internal and external stakeholders. This position will work independently and require minimal coaching from leaders while managing complex and specialty caseloads of claims for assigned CPI/VSI/GAP clients. This position will manage a heavy caseload of claims (150 or more) with a specific determined financial limit of $20,000 to $25,000.

Requirements

• High School Diploma or GED required.
• 5-7 years of work-related experience required.
• Requires Property and Casualty license in states Allied does business.

Responsibilities

• Adjudication of Claims (70%)
• Investigate and determine appropriate application of coverage.
• Make recommendations to management for settlement amounts outside of authority limits.
• Accurately evaluate and determine settlement of complex/specialty claims.
• Proficiently understand the use of policy coverage and be able to recognize questionable coverage and situations that will require supervisor involvement.
• Review all claim assignments in detail.
• Ensure proper diary management on all claims.
• Ability to manage the full-life cycle of all assigned claim files.
• Requires a deep technical expertise and ability to utilize multiple systems to handle/process claims.
• In depth understanding of overall claim operations and key stakeholders.
• Excellent oral, written, interpersonal communication and keyboarding skills along with the capacity to multi-task in a structured work environment.
• Follow all regulatory and jurisdictional requirements associated with state regulations and guidelines.
• Serve as a resource for less experienced staff, providing training and support as appropriate.
• Recognize and solve obstacles that occur in the claims process without supervisory approval.
• Able to clearly communicate concise action plans, and present plans for moving the claim to conclusion.
• Involve supervisor when handling claims that trigger special service instructions.
• Exercise proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to appropriately settle the claim.
• Interact extensively with various parties involved in the claim process.
• Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges.
• Analytical skill necessary to make decisions and resolve complex issues inherent in handling losses.
• Use discretion and independent judgment in claim handling.
• May provide training and mentoring to adjusters.
• Make decisions in an informed, confident and timely manner.
• Service Delivery to customers (10%)
• Promptly answer inbound calls.
• Maintain a record of call regarding claims in appropriate system.
• Effectively communicate to clients/borrower.
• Promptly and efficiently respond to all email communications (4-8 hrs).
• Follow policy/procedures regarding calls.
• Thoroughly resolve client escalations for their assigned financial institutions and assist with resolution of any other escalations as assigned by leadership.
• Thorough understanding of claims compliance and state mandated regulations (20%)
• Maintain appropriate adjusters license in all states required.
• Follow state by state requirement on continuing education.
• Follow mandates required by state statues and regulation regarding all claim adjudication.
• Comply with timeliness, accuracy and service standards of the company and underwriters.
• Other duties as may be assigned.

Benefits

• Medical, dental and vision insurance coverage.
• 100% company-paid life and disability coverage.
• 401k options with company match.
• Three weeks PTO by the end of the first year.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Merchant Wholesalers, Nondurable Goods
• Education Level: High school or GED