Claims Analyst

Allied Solutions LLC•Plano, TX

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
Investigate and determine appropriate application of coverage.
Makes 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.
Serves as a resource for less experienced staff, providing training and support as appropriate.
Recognizes and solves obstacles that occurs 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.
Exercises proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to appropriately settle the claim.
Interacts 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.
Uses discretion and independent judgment in claim handling
May provide training and mentoring to adjusters.
Makes decisions in an informed, confident and timely manner
Proven track record of handling specialty or complex claims
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
Maintains 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
Complies with timeliness, accuracy and service standards of the company and underwriters.
Other duties as may be assigned.