Lead Claims Analyst

6 days ago

New York, United States The Council of School Supervisors and Administrators of the City of New York Full time

The Council of School Supervisors and Administrators of the City of New York, Local 1, American Federation of School Administrators, AFL-CIO (“CSA”) located in New York, NY is seeking a full-time Lead Claims Analyst, reporting directly to the Welfare Fund Administrator. The Lead Claims Analyst will oversee and manage CSA’s claims processing operations. This is an in-person position and will require the Lead Claims Analyst to work in the New York City office on a daily basis.


CSA is a labor union which represents New York City Public School Principals, Assistant Principals, Supervisors, Educational Administrators and Directors of city-funded Day Care Centers. CSA serves 17,000 in service and retired members along with their dependents. CSA administers supplemental benefits that extend the major medical health plan provided by NYC and are designed to meet the special needs of the membership. Benefits include optical, hearing aid, home health aide, prescription coverage, dental, and supplemental medical/catastrophic stop loss coverage. Please visit to learn more about CSA.


Key Responsibilities:


Responsibilities include, but may not be limited to:


  • Utilize claims software to process and adjudicate claims accurately and efficiently;
  • Lead and train a team of claims analysts, providing guidance and training as needed to ensure high performance and productivity using newly acquired Claims Software;
  • Serve as a subject matter expert on CSA’s supplemental benefits package, learning and understanding its intricacies in order to assist with member claims effectively;
  • Collaborate with CSA claims staff to resolve complex claims issues and improve overall claims processing procedures;
  • Monitor claim trends and identify areas for process improvement or optimization;
  • Maintain compliance with regulatory requirements and company policies; and
  • Respond to member questions regarding claims processing and reimbursements.


Requirements:


The ideal candidate will meet the following requirements:


  • Work Experience: Minimum of five (5) years of relevant claims processing experience is required. Prior experience in the healthcare or insurance industry is strongly preferred. Experience with Taft-Hartley plans and/or Benesys benefit administration software is a plus. Educational Background: Bachelor's degree in a related field or equivalent work experience.


Special Skills or Credentials:


  • Proficiency in current technology including, but not limited to, claims administration software and Microsoft Office.
  • Strong communication skills, both verbal and written, with the ability to effectively convey complex information to both colleagues and union members.
  • Proven leadership abilities, including the ability to motivate and develop a team.
  • Detail oriented with excellent problem-solving skills.
  • Ability to effectively train team members are essential for success in this role.
  • Highly emotionally intelligent with strong interpersonal skills.
  • Proven record of confidentiality, improvement and ability to build consensus and improve moral within teams.
  • High customer satisfaction rating.


To Apply:


CSA offers a competitive salary and a comprehensive benefits package. CSA is an affirmative action employer and encourage applications from all qualified candidates regardless of gender, race, ethnicity, age, sexual orientation, marital status, religion, or disability.


To apply, please send your resume and salary requirements to atcresumes@segalco.com. Please include job reference code 0624CSALCALI in the subject line or with your application.

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