Claims Analyst
2 weeks ago
At OMS National Insurance Co. our mission is simple. We are dedicated to serving and protecting oral and maxillofacial surgeons and dental professionals nationwide. If you are a legal or claims professional, and wish to be part of a growing, well-respected industry leader, OMSNIC could be the right place for you.
We offer a robust array of benefits to support our employees
- generous PTO, long-term incentive plan, affordable and comprehensive benefits plans, a hybrid work schedule, tuition assistance and opportunities to advance your career. What makes us special is our collaborative culture and the impact we make as a team.
Claims Analysts have direct contact with our policyholder doctors and are regarded as trusted partners, managing an assigned caseload of claims. This includes the investigation, evaluation, and resolution of both pre-litigation and litigated matters.
**WHAT YOU WILL DO**:
**Claims Management**
Evaluate coverage
Assign and collaborate with defense counsel
Review and analyze medical records
Investigate and evaluate issues of liability, causation, and damages, proactively moving the files toward resolution
Participate in the formulation of case strategy
Negotiate claims in a settle posture
Evaluate indemnity and expense reserves
Prepare Comprehensive Claim Reports
Present claims to management and for internal review
Keep policyholders informed of the status
Timely and accurately document claim files
Help maintain claim file data for accurate reporting
Review and approve bills
**General**:
Planning and participation in Risk Management and Defense Counsel Seminars
Contribute to departmental and company goals, initiatives and projects
May attend or participate in training and development programs
May participate in the training and development of new hires
Occasional travel will be required
**EDUCATION AND EXPERIENCE**:
Bachelor’s Degree required; might consider a demonstrated equivalent professional experience
JD preferred
Minimum 3 years’ experience in the legal, insurance, or medical professional liability claims management field
Working understanding of medical records
Microsoft Office Suite proficiency with emphasis on Word, Excel and PowerPoint
**COMPETENCIES**:
Strong organizational and time management skills, ability to meet deadlines
Effective written and oral communication skills to provide information in a clear and concise manner and to communicate with variety of stakeholders
Effective analytical and critical thinking skills to analyze facts and draw conclusions to make recommendations and resolve issues
Ability to prepare robust reporting yet provide a broad scope overview and summary, when appropriate
Superior customer service skills and ability to actively listen
Strong interpersonal skills with ability to interact with policyholders, legal professionals, management, co-workers, agents, committee and board members, and external venders
Strong mediation and negotiation skills
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