Claims Analyst

Remote - United States

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Risk Strategies
A leading specialty risk management consultancy and insurance broker offering smarter, practical approaches to risk mitigation and custom insurance program design for businesses, educational and government institutions, as well as successful...
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Risk Strategies is a top national specialty insurance brokerage and risk management firm with over 100 offices and 2,500 employees across the US & Canada. We thrive on our passion to be ranked a Best Places to Work since 2018 by our most important asset, our employees.

Due to growth, our team seeks a tenured Claims Analyst to work closely with and report to the SVP/Head of Client Services for the reinsurance team to ensure the industry leading claims support that our clients expect. This position will assist the brokers by collecting claims data from clients and importing the data into a proprietary claims system and reporting application. Active communication with clients regarding claim reporting on a monthly basis, interacting internally with brokers, AE’s and financial analysts regarding client claims data and reporting, and externally with insurers and reinsurers’ claims staff regarding claims submissions, adjudications and recoveries are key components for success in this role.

Primary Responsibilities and Duties:

  • Monitoring client reporting timeliness, deadlines and reviewing claims submissions for completeness
  • Working in Excel or Access to prepare data for entry into claims system, creating submissions and sending monthly claims submissions to carriers/reinsurers and client
  • Entering data into claims system and/or tracking spreadsheets and ensuring all data is backed up
  • Responsible for the flow of data, additional requests and appeals between clients and insurers/reinsurers
  • Communicating with insurers/reinsurers regarding suspected claims errors and appealing on behalf of the client
  • Assisting the broking team with claims inquiries and reporting as directed
  • Working with accounting team regarding reimbursement of claims between insurers/reinsurers

Requirements

  • Minimum of 5-7 years of relevant experience. Health insurance industry experience a plus
  • Well versed in MS Access, Excel and Word
  • Ability to read and interpret insurance documents` and reinsurance treaties
  • Ability to set goals, multitask and prioritize workload with exceptional organization and time-management skills
  • Self-starter, professional and assertive
  • Proficient knowledge of medical terminology and medical coding
Job region(s): North America
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