Claims Operations Specialist

5 hours ago

Jacksonville, Florida, United States LotSolutions, Inc. Full time
Job Title: Claims Operations Analyst

Job Summary:

The Claims Operations Analyst plays a crucial role in enhancing claims operational efficiency and productivity. This position involves gathering, analyzing, and specifying business needs of stakeholders, including customers and end users. The Analyst will collaborate with key stakeholders to collect and consolidate user requirements, ensuring the development of appropriate technology solutions.

Key Responsibilities:

  • Identify and champion strategies to improve operational efficiency and communicate findings and recommendations to key stakeholders.
  • Collaborate with project sponsors to determine project scope and vision.
  • Clearly identify project stakeholders and establish user classes, as well as their characteristics.
  • Conduct interviews to gather user requirements via workshops, questionnaires, surveys, site visits, workflow storyboards, use cases, scenarios, and other methods.
  • Identify and establish scope and parameters of requirements analysis on a project-by-project basis to define project impact, outcome criteria, and metrics.
  • Work with stakeholders and project team to prioritize collected requirements.
  • Evaluate, analyze, and communicate systems requirements on a continuing basis and maintain systems processes, including the delivery of monthly status reports to all appropriate parties.
  • Support and maintain the monthly flow of claims data files into 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.
  • Provide training and guidance as required.

Requirements:

  • High level of professional standards of accuracy and work product.
  • Requires knowledge of claims bordereaux verification.
  • Proven experience with business and technical requirements analysis, elicitation, modeling, verification, and methodology development.
  • Ability to create systematic and consistent requirements specifications in both technical and user-friendly language.
  • Exceptional analytical skills with the ability to apply them to systems issues and products as required.
  • Demonstrated project management skills and project management software skills, including planning, organizing, and managing resources.
  • Ability to exercise independent judgment and take effective action.
  • Excellent listening, interpersonal, written, and oral communication skills.
  • Logical and efficient, with keen attention to detail.
  • Highly self-motivated and directed.
  • Ability to effectively prioritize and execute tasks while under pressure.

What We Offer:

LotSolutions, Inc. offers a full benefit package, including medical, dental, life, vision, company-paid short/long-term disability, 401(k), tuition assistance, and more.

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