Senior Claims Operations Analyst
Found in: Resume Library US A2 - 2 weeks ago
Position Summary:
Under the general direction of the Claims Data Operations Manager, the Senior Claims Analyst provides a variety of critical operational support services to the Claim Department, its business partners and its clients related to the handling of returned checks, processing of refunds, escheatment review, paying of invoices and fees, and analysis of Control request.
Responsibilities:
Provides subject matter expertise on various complex projects that are assigned to Business Support Services for handling to completion i.e., Take Overs, Reverse Take Overs, Novations/Buybacks, Carrier program Funding Conversions, and claim Split Billing processes
Coordinates and monitors the completion of all tasks among various operational areas in relation to complex operational projects
Acts as subject matter experts for the analysis and evaluation of claim systems, software, equipment and programs and provides recommendations for implementation.
Assists in the development, testing, and implementation of new and existing programs, procedures, and system enhancements in support of Broadspire Claim and various business departments
Develops and maintains a favorable working relationship with internal and external customers
Coordinates claim system related tasks in conjunction with Finance team for any Break Payment items; maintains and monitors monthly list of clients that are on break payment and reasons
Determines and creates appropriate user access to the Lotus Notes User Distribution Groups
Provides direction to the Claim department for any questions related to handling of Prefund requests and the claim system process impacts
Provides additional user level expertise to ICT Help Desk Support for claim system issues
Oversees ISOVerisk Vendor relationship; i.e., maintains ISO account list, user access IDs, distribution of any ISO error reports, and managing annual fee structure and new product implementation
Analyzes, research and write internal procedural changes, workflows and requirements in support of various business areas Determines business impact and recommends and/or initiates appropriate action
Participates in the research, writing, publishing and maintenance of operating procedures and user manuals
Provides guidance and/or training to Claim Offices on existing claim systems and procedures
Provides assistance to various Broadspire Departments identifying, researching and correction of indicative and financial data errors
Maintains applicable log books as well as adheres to established guidelines of applying reimbursements to claim files and/or mailing of reimbursement/miscellaneous checks to appropriate lockbox
Provides backup coverage to others in Claim Operations as needed and/or requested.
Maintains professional and positive relationship with Boadspires’ File Storage Vendor, including ensuring payment of fees and user requirements related to access IDs, file retention, as well as responding to various business area questions or issues
Participates in ad hoc assignments and special projects as assigned
Upholds the Crawford Code of Conduct
Requirements:
Three or more years of experience in Broadspire Business Support Services, Claim Systems or Claim Operations or the equivalent, demonstrating a good knowledge of claim systems and field operations.
Education equivalent to graduation from college or the equivalent in related work experience.
Demonstrates effective customer relations skills.
Demonstrates sound analytical skills.
Demonstrates a comprehensive knowledge of claim system functions and the relationship of client information to accurate claim processing and reporting.
Demonstrate ability to work accurately with attention to detail and customer expectations.
Demonstrate effective and diplomatic oral and written communications skills
About Us:
Why Crawford?
Because a claim is more than a number — it’s a person, a child, a friend. It’s anyone who looks to Crawford on their worst days. And by helping to restore their lives, we are helping to restore our community – one claim at a time.
At Crawford, employees are empowered to grow, emboldened to act and inspired to innovate. Our industry-leading team pioneers new solutions for the industries and customers we serve. We’re looking for the next generation of leaders to take this journey with us.
We hail from more than 70 countries and speak dozens of languages, reflecting the global fabric of the audience we serve. Though our reach is vast, we proudly operate as One Crawford: united in purpose, vision and values. Learn more at .
When you accept a job with Crawford, you become a part of the One Crawford family.
Our total compensation plans provide each of our employees with far more than just a great salary
Pay and incentive plans that recognize performance excellence
Benefit programs that empower financial, physical, and mental wellness
Training programs that promote continuous learning and career progression while enhancing job performance
that give back to the communities in which we live and work
A culture of respect, collaboration, entrepreneurial spirit and inclusion
Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V Crawford & Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means.
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