Claims Analyst

Destin, FL

Posted: 03/04/2019 Job Number: 2630
    JOB DESCRIPTION FOR A CLAIMS ANALYST
 
 

 

 

Reports To:

VP of Claims Management

Status:

Non-Exempt

 

 

Job Summary:

To assist with the maintenance of the day-to-day claims processes and work with our clients/Insurers/TPAs/Managers to improve the efficiency, accuracy and capacity for claim processing

Essential Functions/Activities:

 
  • Responsible for coordinating, processing and handling of claims/loss notices/incident reports received by the company.
  • Review/Prepare Accord forms/Loss notices
  • Contact clients or other involved parties to obtain any missing relevant information for claim set up and reporting
  • Forward Accord forms to insurance carriers/third party administrators/risk managers/independent adjusters/claim managers
  • Prepare/Set up internal claim files with reporting/distribution to Claim Managers
  • Update claim files on a regular basis with relevant claim information, such as assigned adjuster name/contact info/claim no, etc.
  • Review claim files for potential closure as directed by claim managers
  • Respond to daily claims procedure inquiries as well as individual claim questions from clients, adjusters, agents, etc.
  • Assist claim managers with reporting requests/acknowledgments/letters/reports/spreadsheets as needed
  • Ensure Claim Contact list updated with current contact names/phone numbers, e-mails, etc.
  • Assist with any Audits/Ad hoc projects as needed

 

Minimum Essential Requirements:

 

·         Licensure:

o     Must obtain a   Florida state adjuster license (620) within 6 months

·         Education:

oHigh School Diploma or equivalency

·         Experience:

o   1-2 years claims/insurance experience preferred

·         Skills:

oStrong organizational skills and strong ability to multi-task

oAdvanced knowledge of MS Outlook, Word and Excel

 


 

Essential Mental Functions:

 

·         Ability to understand written sentences and paragraphs in work related documents.

·         Ability to talk to others to convey information effectively

·         Ability to choose the right mathematical method or formula to solve a problem

·         The ability to listen to and understand the information and ideas presented through spoken words and sentences

·         Ability to use logic and reasoning to identify the strengths, and weaknesses of alterative solutions, conclusions or approaches to a problem

·         Ability to analyze and evaluate results to choose the best solutions and solve problems on complex issues

·         Ability to assess the value, importance or quality of things or people

·         Ability to pay attention to detail

·         Ability to prioritize

·         Ability to handle stress of short time constraints

Essential Physical Functions:

·         Ability to occasionally lift at least 10lbs.

·         Ability to sit/work at a computer for extended periods of time

Equipment Used Telephone

·         Computer/printer; MS Outlook; Applied – Epic Software

·         Fax/ Copy/ Scanner

·         10 key Calculator

Additional Comments:

·         Ability to work independently or in a team environment

·         Ability to work in a constantly changing environment

·         Maintain acceptable standards with respect to company attendance policy

·         All other duties as assigned
     
 

 

 

 

 

 

 

 

 
   

 
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