Claims Analyst - Complex Claims

Claims Analyst

The Claims Analyst will develop and maintain client relationships through advising and providing advocacy on claims related issues. Perform claim reviews and status updates to ensure that claims are properly set up, coverage positions are received and appropriate, and that the claims are moving towards closure or resolution in a timely manner. Provide routine status updates to service team on open claims. Communicate with claims professionals, clients and internal staff, and achieve successful results.

Momentous Insurance, A Marsh McLennan Agency provides commercial insurance, commercial entertainment, film and tv insurance, employee health & benefits insurance, and private client insurance solutions to organizations and individuals seeking limitless possibilities. With 9,000 colleagues and 170 offices across North America, we combine the personalized service model of a local consultant with the global resources of the world's leading professional services firm, Marsh.

Essential Duties & Responsibilities

• Provide effective claims management.
• Develop and maintain computer-based task system of events and diary of routine status updates for claims including dates critical to ensuring claims are properly set up, a timely coverage position is issued, a claims adjuster is assigned, defense counsel is assigned (when applicable), and status update of claims progress. Actively manage assigned claims independently.
• Be available and responsive to clients during their regular business hours to provide claim support and guidance according to the expected service level standards of our clients.
• Review and summarize coverage positions, including evaluation of coverage denials and reservations of rights, as to appropriateness and present analysis and recommendations to client.
• Report in a timely manner all new claims and establish claims files with appropriate tender documentation, adjuster contact information, and coverage positions.
• Review, strategize and make recommendations of next steps for complex claims that may involve multiple carriers or layers of coverage.
• Identify when claims intervention is necessary and escalate issues when appropriate and with guidance from the Complex Claims Manager.
• Appropriately document internal file, including maintaining appropriate file notes and documentation using the internal client management system.
• Establish and develop client and company relationships to provide the most effective claims advocacy and support.
• Ensure key internal associates and clients are apprised of claim status.
• Develop working relationships with dedicated claim liaisons from insurance carriers to support the most effective way to successfully handle claims.
• Monitor claim files and obtain routine status updates, including providing regular status updates to service teams. Respond to requests for updates or questions from the service team or clients.
• Identify and notify producers and service teams of large complex claims, claims that have potential coverage obstacles, denied or disputed claims and your strategy to work with the adjuster to resolve issues.
• Establish and develop client and company relationships to ensure good communication for the most effective claims handling.
• Take on assignments and duties as requested by the Complex Claims

Education and/or Experience

Successful candidate will be a service-oriented individual with high personal standards and a hands-on work style. This position requires an individual who is comfortable working at a varying pace, managing multiple tasks and deadlines simultaneously, adjusting priorities often, and managing frequent interruptions.

This position interacts with and provides service to internal associates and has high levels of contact with external vendors. The Claims Analyst must be positive and approachable, and work effectively with diverse personalities. In addition, the following is required unless otherwise noted:

• Successful work history to include four (4) years of experience in a professional office setting directly related to job responsibilities specified above.
• A Bachelor's Degree or advanced paralegal certificate is highly desired.
• Maintain skills and knowledge through independent study, seminars and educational industry resources available for claims management or other job specific specialty areas.
• Proficiency with personal computers and Microsoft Office applications (i.e., Word, Excel and PowerPoint) with the ability to operate standard office equipment.
• Skill in organizing resources and establishing priorities.
• Demonstrated ability to resolve problems and present results neatly, with clarity and precision in oral and written form.
• Demonstrated ability to develop, plan, and implement short- and long-range goals.
• Maintain a valid Driver's License & have reliable transportation.

Work Environment & Physical Demands

• Ability to use computer keyboard and sit in a stationary position for extended periods.
• Work is performed in a typical interior/office work environment.
• 15% - 20% travel may be required. Travel consists of 1 2 overnight trips per year covering areas both in and out of state.
• Extended work hours (10 12 hrs/day) required on occasion due to client meetings and industry functions that begin well before the workday, and may extend well into the evening.

Valuable benefits.

We value and respect the impact our colleagues make every day both inside and outside our organization. We've built a culture that promotes colleague well-being through robust benefit programs and resources, encourages professional and personal development, and celebrates opportunities to pursue the projects and causes that give colleagues fulfilment outside of work.

Some benefits included in this role are:

• Generous time off
• Tuition reimbursement and professional development opportunities
• Charitable contribution match programs
• Stock purchase opportunities

Marsh McLennan and its affiliates are EEO Minority/Female/Disability/Vet/Sexual Orientation/Gender Identity employers.