Claims Intelligence Analyst (SIU)

Plymouth Rock Assurance • Woodbridge Township, NJ

12d

About The Position

This position is responsible for applying knowledge and experience to our claim
processes, data analytics and SIU investigations to support the development and
implementation of technical and analytical solutions to address SIU business and
analytical needs. This individual will implement operational, fraud and
analytical models, and organize data input and output to develop and communicate
recommendations.

The successful candidate will have the abilities necessary to create business
intelligence reports, social media assessments, link analysis and other
sophisticated data mining activities.

Requirements

• Knowledge of information technology and data analysis methodologies, including understanding how leveraging technology can proactively impact suspicious/fraud activity.
• The ability to read and interpret complex information and explain it to others; listen actively, stay focused, identify hidden messages, and draw out underlying issues.
• Organizational skills with the ability to organize data in manageable subsets and the ability to get requests completed timely and accurately.
• Proven excellence in critical thinking and conceptual skills’ creative use of varied research methods.
• Advanced proficiency with Microsoft Tools, included but not limited to Excel and Visio. Tableau knowledge would also be preferred.
• A minimum of a four-year college degree. Preferred in the field of information technology or criminal justice.
• Two years prior Property and Casualty PIP claims experience preferred.

Nice To Haves

• Insurance related designations preferred.

Responsibilities

• Demonstrated capability to collaborate with the Shift team and internal partners on proof-of-concept initiative, while proactively assuming a leadership role in assessing and interpreting Shift project results
• The ability to present to management in a clear and concise manner the approach to address potential suspicious/fraud activity that could impact the company.
• Identify patterns and trends using our internal claim, medical and policy data tables to determine if further investigation is warranted.
• Proven ability to acquire, analyze and interpret information from various data sources and formulate theories regarding trends and patterns required.
• The ability to receive investigative requests from the field staff, internal claim associates and underwriting to discover developing patterns, trends and changes in suspicious activity.
• Proactively monitor industry information bulletins and NICB alerts to determine potential exposure to the company.
• Conduct data mining activities and data analysis using available tools and internal databases.
• The ability to work with our product department on predictive analytics and pattern analysis initiatives.
• Collaborate with others in developing visual analytics to support complex investigation data involving multiple claims and multiple entities participating in the fraudulent schemes.
• Utilize data visualization tools and/or other analytics software to create reports for the team and/or management on the territory specific SIU operational performance.
• Develop metrics to measure various characteristics of the SIU business to replicate and improve current measures and create new metrics and ways to view and analyze results.
• Assist with SIU Vendor Management during high volume referral activity.
• Manage claim or policy investigation throughout process.

Benefits

• 4 weeks accrued paid time off, 8 paid national holidays per year, and 2 floating holidays
• Low cost and excellent coverage health insurance options that start on Day 1 (medical, dental, vision)
• Annual 401(k) Employer Contribution
• Free onsite gym and health center at our Woodbridge Location
• Resources to promote Professional Development (LinkedIn Learning and licensure assistance)
• Robust health and wellness program and fitness reimbursements
• Various Paid Family leave options including Paid Parental Leave
• Tuition Reimbursement

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 501-1,000 employees