Fraud Claims Analyst

Position Overview:

The Contractor Operations Claims Analyst will be responsible for data analysis, reporting, and auditing to ensure that internal operations teams and HomeServe's third- party contractor network are administering claims in accordance with policy terms and conditions, processes, and pre-negotiated rate schedules. The Claims Analyst will utilize claims data and reporting to identify opportunities to improve financial underwriting performance, operational efficiencies, and the customer experience. As well, the
incumbent will work independently and collaboratively across both the Operations and Finance teams to develop analytical reports to better understand opportunities for cost avoidance. The Claims Analyst will conduct ad hoc reviews and regular deep dives of identified trends and opportunities, and work with key business stakeholders to provide summaries of findings and recommended actions. This position is onsite and will report into our office in Chattanooga, TN.

Responsibilities:

• utilize claims data to identify unfavorable trends or opportunities in claims performance to determine where additional analysis is necessary.
• Conduct audits based on findings to analyze the unfavorable trends impacting business claims performance as well as identify and audit any contractors, and/or internal operations team members, not adhering to pre-negotiated rate schedules, processes, and/or policy terms and conditions.
• Accurately identify, document, and share findings and opportunities for improvement. Create and document action plans for any business process changes identified during audits and assist in guiding the implementation of the changes.
• Develop clear framework for tracking and monitoring the implementation of business process changes and continually assess the impact of the changes on claims performance.
• Communicate insightful summaries to key business stakeholders on findings along with recommended actions for improvement tailored to the needs of the department.
• Responsible for completing various audits monthly, quarterly, or annually within Contractor Management to remain SOX compliant.
• Keep current on operational processes, contractor rate schedules, repair methods and practices, and policy terms and conditions.
• Build and maintain excellent relationships with key business stakeholders including but not limited to the Regional Operations Managers, Cost Authorization,
  Contractor Administration, Repair Management, and Finance.
• Meet KPI targets established by the company.
• Perform other duties as assigned.

Essential Functions:

Essential Job Function

% of Time on Function

Completing contractor or claims audits to provide actionable feedback to the business and ensure performance & quality goals are met or exceeded.

50%

Generating monthly, weekly, & daily reports to support contractor management in meeting or exceeding department goals

40%

Reviewing Fraud reporting to identify potentially fraudulent customers or contractors to investigation.

10%

Total

100%

Job Requirements:

• Bachelor's degree in business, finance, or related field
• At least 2 years of experience in data analysis, reporting, auditing, or related field and demonstrates a good working knowledge of Contractor Operations processes.
• Advanced knowledge of Microsoft Excel and proficient in other Microsoft applications (Word/PowerPoint).
• Experience with field service management applications such as ServiceBench, Service Titan or Dispatch Technologies preferred.
• Strong analytical mind, critical thinking, and logical reasoning with the ability to make solution-oriented decisions that will guide business action.
• Excellent and accurate data entry skills with strong attention to detail.
• Self-driven and exceptional organizational, time management, and independent problem-solving skills with the ability to work in a team environment and independently.
• Feel comfortable working in an autonomous environment where you are expected to be self-managed, while responsible for meeting or exceeding personal and departmental goals.
• Strong time management and organization skills and the ability to shift priorities based on the needs of the business.
• Adept at managing multiple priorities and tasks in a fast-paced environment.
• Excellent written and verbal communication skills.
• Broad knowledge of home repair methods including plumbing, HVAC, and electrical

In return, we offer:

• Competitive compensation
• Career development and advancement opportunities
• Casual attire throughout the week
• Friendly, open and team oriented work atmosphere
• Excellent benefits including generous medical, vision, dental and life & disability insurance
• 401(k) plan with a company match
• Eligibility to enroll in up to two HomeServe coverage plans paid for by the company

Minimum Physical Requirements:

The physical demands described represent those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions of the position for which they work. While performing the duties of this position, the employee is regularly required to listen, talk and hear. The employee frequently is required to use hands or fingers, handle or feel objects, tools, or controls while executing tasks like working on a computer or talking on the telephone. The employee is occasionally required to stand; walk; sit; and reach with hands and arms. The employee must occasionally lift and/or move up to 15 pounds. Specific vision abilities required by this position include close vision, distance vision, and the ability to adjust focus. The noise level in the work environment is usually moderate to low.

HomeServe USA is an equal opportunity employer.