Claims & Insurance Analyst Sr.

UPMC•Harrisburg, PA

2d•Hybrid

About The Position

Manages complex claims involving primary and excess insurance coverages, significant litigation, and extensive liability; monitors claims work on complicated claims; assumes responsibility for reviewing claims for settlement potential; managing the litigation services provided by all subcontracted defense attorneys; and conducts comprehensive audits of litigated files. This position will work on site for the first 3 months for training and hybrid (2-3 days in office), once trained.

Requirements

Associate's degree in Business, Communications, or a related field and 5 years of claims management experience dealing with indemnity claims OR Bachelor's degree in Business, Communications, or a related field and 3 years of claims management experience dealing with indemnity claims.
Extensive technical knowledge of claims management and settlements required.
Excellent negotiating skills.
Excellent interpersonal skills.
Leadership abilities.
Excellent written and verbal communication skills.
Ability to communicate clearly via telephone.
Good personal computer skills.

Responsibilities

Identify and negotiate cost effective claim resolutions/settlements up to designated financial authority or prepare for review/approval by President.
Complete special projects and contribute to daily Risk Management Initiatives as directed by the President or Director.
Serve as the representative of UPMC Corporate & Captive in regard to communicating all legal aspects of claims activity between UPMC and the various commercial insurers and their respective defense firms.
Assist the Director of Corporate & Captive Insurance (Director) with administrating all commercial lines of coverage, including all claims activities associated with the various UPMC commercial policies.
Assist the President and Director of annual policy review of each individual insurance policy written through UPMC Captive Insurance Program.
Prepare and issue all reservation of rights letters on behalf of UPMC Captive Insurance Program, including submitting and coordinating all necessary documentation to commercial carriers of potential and filed lawsuits.
Review daily correspondence to maintain comprehensive claims database with settlements, dismissals, demands, financial reserves and trial dates.
Work with the President, Captive Insurance Program & Counsel (President) to evaluate and coordinate in-house and external counsel assignments for each case.
Analyze complex, technically challenging, and/or sensitive employee related and third party claims that are submitted for coverage under one of, but not limited to, UPMC Captive policies; Directors & Officers Liability, including Employment Practice Liability, Managed Care Errors & Omissions, General Liability and Professional (malpractice) liability.
Prepare all legal correspondence to all program insured(s) and attorneys.
Field a wide variety of phone calls/emails from insureds regarding insurance coverage and claims questions and what to expect during the legal discovery process.
Coordinate and prepare all necessary information for review by President.
Maintain excellent professional relationships with clients, internal as well as external.
Manage the litigation services provided by all subcontracted defense attorneys and conduct comprehensive audits of litigated claim files.
Monitor excess insurance coverages and reserves on a continuous basis.
Provide direction to claims staff (insurance brokers and carriers) to ensure compliance with Claims Service Standards as well as continuously refining and improving claims handling procedures for UPMC's Corporate & Captive Insurance Program.
Work with President to develop, assign, and carefully monitor reserves for each claim.
Coordinate and conduct regular claim reviews with internal and external staff/clients/defense attorneys.