Reinsurance Claims Modelling Analyst

Enstar Group

4d • $115,000 - $135,000 • Onsite

About The Position

Responsible for addressing all claim issues related to WC Assumed Modelled Accounts assigned by gathering information necessary to make informed and responsible decisions to bring claims to appropriate resolution.

Requirements

• Bachelor’s degree or higher in Mathematics, Statistics, Finance, Business or a related field.
• 5+ years claims analysis experience with a Reinsurance/Insurance Carrier and/or experience with reviewing and evaluating WC claim reserves.
• General understanding of legal principles as they pertain to reinsurance claims
• Strong technical knowledge of Workers’ Compensation claims as well as State specific claim handling guidelines.
• Requires the ability to understand the various reinsurance agreements which govern these lines of business, as well as the ability to comprehend complex loss presentations received by ceding companies.
• Proficiency in Microsoft Excel
• Knowledge of how to utilize quantitative, statistical and mathematical financial techniques for fair valuations. Knowledge of data analysis, numeric reasoning and overall numeric proficiency.
• Knowledge of workers’ compensation laws, policies and procedures.
• Knowledge to collect and analyse large amounts of information, extract its essence, and incorporate the findings into valuation models and processes.
• Ability to work independently
• Ability to follow instructions, respond to management direction and solicit feedback to improve performance.
• Ability to demonstrate accuracy and thoroughness, monitor own work to ensure quality and apply feedback to improve performance.
• Ability to adapt to changes in the work environment, manage competing demands and is able to deal with frequent change, delays or unexpected events.
• Ability to identify and resolve problems in a timely manner, gather and analysis information with good attention to detail.
• Detail oriented
• Organizational skills
• Ability to multi-task
• Computer skills (Microsoft applications)
• Excellent written and verbal communication skills

Nice To Haves

• Learning and development are a fundamental part of every employee's career journey with Enstar. Supporting growth and career progression is key to how we engage our people - helping them to learn, grow and succeed at Enstar.
• Professional Qualifications and Study Support: We support employees who wish to take professional qualifications aligned to their role and career development.
• Training, Conferences & Seminars: As a global organisation, we work with many professional bodies to provide access to training programmes, conferences, seminars and continuing professional development (CPD) opportunities.
• Digital Learning Hub: Our digital learning hub, LinkedIn Learning, offers a wide range of self-serve resources, including courses, videos, eBooks, and audio books, to help employees build news skills and deepen their knowledge.
• We also invest in physical, mental and financial wellbeing initiatives for our employees. Supportive teams, inspiring work and a positive working environment all contribute to our collective wellbeing. Beyond the workplace, we strive to make a positive influence in our communities and to continuously reduce our impact on the environment.
• Our annual Inclusivity Index puts Enstar ahead of the industry in terms of promoting an inclusive and welcome working environment. We’re an equal opportunity employer and believe that our inclusive environment creates an authentic working culture. We don’t discriminate on the basis of age, physical or mental disability, gender reassignment, marriage and civil partnership, pregnancy and carer status, race (including colour, nationality, and ethnic or national origin), religion or belief, sex and sexual orientation. Enstar is committed in providing an accessible recruitment experience for all those interested in working with us. Please let your Enstar Recruitment Partner know if you require any reasonable accommodation during the application process due to a disability to enable you to fully participate in our recruitment process.

Responsibilities

• Within established authority administers claims for assigned Assumed accounts. Conducts coverage verification, investigation, evaluation, reserving and authorization of claims payments and recovery.
• Manage claim activity and monitor all claim development for assigned accounts
• Alert Management of significant loss development/activity
• Documents modelling procedures and ensures auditability for model priced positions; prepares and maintains on-going documentation efforts with regard to valuation policies, internal controls, processes and results
• Assists and supports manager with review and analysis of results, practices, policies and procedures for portfolio valuation
• Assists with preparation and documentation for an executive-level Valuations, focusing on results, key pricing and valuation initiatives and decisions.
• Evaluate and investigate claims to confirm coverage and identify any potential issues
• Ensure proper reserving of reported claims through utilization of additional case reserves, proper documentation and disposition of individual excess of loss and pro rata accounts.
• Ensure accuracy of processed claims payments. Coordinates with operations and accounting to confirm processing of prompt payments
• Maintain accurate data of payments, reserves, scanned documents, new mail, etc.
• Maintain integrity of imaged claim files and maintain a diary system for assigned files
• Analyze and produce reports highlighting large losses, coverage and critical issues for review by claims management and actuarial.
• Produce and analyze specific account data and generate reports in preparation for claim audits.
• Support reinsurance audits which will utilize the specialized skill developed during this person’s career to understand whether complex claims have been handled and ceded appropriately.
• Work with external customers to address questions, resolve problems and maintain rapport.
• In addition to the above key responsibilities, may be required to undertake other duties from time to time as the Company may reasonably require.
• Willingness to learn multiple facets of the Company’s work product, including developing an understanding of Reinsurance practices and procedures, Reinsurance contractual terms and conditions, and Claim evaluation.

Benefits

• Best-in-class Medical, Dental, and Vision healthcare for single and family coverage.
• Board-certified doctors and pediatricians are available virtually 24/7 for urgent care.
• Access to Health Savings Account (HSA) or Flexible Spending Account (FSA).
• Access to Dependent Care FSA to cover daycare expenses.
• Access to Employee Assistance Programs (EAP) for health and well-being.
• Optional Pet & Home/Auto Insurance.
• Wellness Reimbursement program (up to $600 annual reimbursement for wellness-related expenses, i.e., gym memberships, massage, etc.).
• 401K retirement plan (company matches up to 6% of employee contribution).
• One paid annual volunteer day.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level