Claims Analyst

St. Catherine of Siena•Melville, NY

28d•$115,000 - $145,000

About The Position

Catholic Health is one of Long Island's finest health and human services agencies. Our health system has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a network of physician practices across the island. At Catholic Health, our primary focus is the way we treat and serve our communities. We work collaboratively to provide compassionate care and utilize evidence based practice to improve outcomes - to every patient, every time. We are committed to caring for Long Island. Be a part of our team of healthcare heroes and discover why Catholic Health was named Long Island's Top Workplace! Job Details The Claims Analyst is responsible for monitoring, analyzing, and reporting on professional liability claims and legal expenses for the health system. This role supports the Risk Management team by maintaining oversight of active litigated claims, reconciling financial data provided by third-party administrators (TPAs), and identifying trends that inform legal and risk mitigation strategies. The position will have significant interface with the system's primary insurance carrier, TPA, defense counsel, and internal stakeholders.

Requirements

J.D. (preferred), but will consider a Bachelor's degree if the candidate possesses other, pertinent industry experience.
5+ years of claim experience, preferably healthcare liability or other professional liability claims.
Strong understanding of legal billing practices, claims processes, and insurance principles.
Experience working with TPAs, insurance carriers, and/or defense counsel.
Proficiency in Excel and data analysis; familiarity with RMIS or similar systems a plus.
High attention to detail with strong analytical and reconciliation skills.
Excellent verbal and written communication skills, especially in cross-functional or legal settings.
Ability to manage multiple priorities in a fast-paced, high-stakes environment.
Comfortable handling confidential and sensitive information with discretion.

Responsibilities

Monitor all professional liability suits through resolution, ensuring accurate tracking of claim status, legal milestones, and financial exposure.
Review and reconcile legal expense reports from the TPA, ensuring alignment with internal records and identifying discrepancies in billing or payments.
Analyze legal spend and claim activity to identify patterns, trends, and opportunities for cost reduction or process improvement.
Collaborate with defense counsel and the TPA to ensure adherence to litigation guidelines and timely reporting of case developments.
Maintain up-to-date claim files and documentation in the Risk Management Information System (RMIS) or other designated platforms.
Prepare periodic reports and dashboards summarizing claim status, reserves, legal expenses, and emerging risks for senior leadership and the Claims Director.
Assist in preparing data and documentation for actuarial reviews, insurance renewals, or board-level reporting.
Support internal audits or compliance initiatives related to claims and legal spend.
Contributes to and consistently applies Catholic Health policies, procedures, and benefits to all customers and/or employees without discrimination.
Employee conducts himself/herself in conformity with the HIPAA Compliance Program and applicable institutional policies and procedures for patient privacy. In addition, employee conducts himself/herself in conformity with the Catholic Health Security policies and procedures.
Every effort has been made to make your job description as complete as possible. However, it in no way states or implies that these are the only duties you will be required to perform. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or is a logical assignment to the position.