The Claims Operations Analyst is responsible for the maintenance of claims data, internal and external loss reporting, and third-party claims bordereaux ingestion. The role requires a keen understanding of Specialty, Credit, and Warranty claims as well as exceptional problem-solving skills and the ability to lead and collaborate with cross-departmental teams.
Primary Job Functions:
- Support and maintain the monthly flow of claims data files within internal data recording and management systems.
- Prepare data entries in accordance with established standards.
- Ensure the accuracy of data, including reconciliations.
- Update data discrepancies identified in reports and systems.
- Recommend and implement process improvements to streamline claims workflows, improve accuracy, and reduce processing time.
- Facilitate communication and collaboration between various stakeholders, including Claims, Underwriting, Actuary, IT, Finance, and Statistical Reporting.
- Maintain documentation of claims processes, ensuring clarity and accuracy for users and IT teams.
- Contribute to project planning, execution, and testing to ensure successful implementation of process improvements.
The above-cited duties and responsibilities describe the general nature and level of work performed by people assigned to the job. They are not intended to be an exhaustive list of all the duties and responsibilities that an incumbent may be expected or asked to perform.Minimum Qualifications:
- 3+ years experience as a Business Analyst, Operations Analyst, or related experience
- Bachelor's degree preferred
- Insurance or claims experience preferred
- Advanced experience in SQL syntax, queries, and database management
Skills and Copentencies Required:
- Familiarity with relevant industry standards and insurance compliance requirements.
- Knowledge of relevant software and claims management systems used for claims processing.
- Demonstrated ability with claims bordereaux production and verification.
- High level of professional standards of accuracy and work product.
- Ability to create systematic and consistent requirements specifications in both technical and user-friendly language.
- Strong business acumen, including data analysis, critical thinking, business analysis, and organizational skills.
- High level of emotional intelligence, influencing skills, and communication skills to enable collaboration with a variety of key stakeholders including senior executive stakeholders.
- Ability to effectively prioritize and execute tasks while under pressure.
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