Claims & Insurance Analyst Sr.

UPMC

Harrisburg, PA

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JOB DETAILS

SKILLS

Analysis Skills, Auditing, Claims Management, Communication Skills, Computer Skills, Customer Relations, Database Administration, Documentation, Executive Assistant Skills , File Audits, Insurance, Insurance Claims, Insurance Sales, Interpersonal Skills, Leadership, Legal, Litigation, Mail Processing, Managed Care, Negotiation Skills, Prepare Correspondence, Presentation/Verbal Skills, Risk Management, Writing Skills

LOCATION

Harrisburg, PA

POSTED

1 day ago

Manages complex claims involving primary and excess insurance coverages, significant litigation, and extensive liability; monitors claims work on complicated claims; assumes responsibility for reviewing claims for settlement potential; managing the litigation services provided by all subcontracted defense attorneys; and conducts comprehensive audits of litigated files.

This position will work on site for the first 3 months for training and hybrid (2-3 days in office), once trained.

Responsibilities:

+ Identify and negotiate cost effective claim resolutions/settlements up to designated financial authority or prepare for review/approval by President.

+ Complete special projects and contribute to daily Risk Management Initiatives as directed by the President or Director.

+ Serve as the representative of UPMC Corporate & Captive in regard to communicating all legal aspects of claims activity between UPMC and the various commercial insurers and their respective defense firms.

+ Assist the Director of Corporate & Captive Insurance (Director) with administrating all commercial lines of coverage, including all claims activities associated with the various UPMC commercial policies.

+ Assist the President and Director of annual policy review of each individual insurance policy written through UPMC Captive Insurance Program.

+ Prepare and issue all reservation of rights letters on behalf of UPMC Captive Insurance Program, including submitting and coordinating all necessary documentation to commercial carriers of potential and filed lawsuits.

+ Review daily correspondence to maintain comprehensive claims database with settlements, dismissals, demands, financial reserves and trial dates.

+ Work with the President, Captive Insurance Program & Counsel (President) to evaluate and coordinate in-house and external counsel assignments for each case.

+ Analyze complex, technically challenging, and/or sensitive employee related and third party claims that are submitted for coverage under one of, but not limited to, UPMC Captive policies; Directors & Officers Liability, including Employment Practice Liability, Managed Care Errors & Omissions, General Liability and Professional (malpractice) liability.

+ Prepare all legal correspondence to all program insured(s) and attorneys.

+ Field a wide variety of phone calls/emails from insureds regarding insurance coverage and claims questions and what to expect during the legal discovery process.

+ Coordinate and prepare all necessary information for review by President.

+ Maintain excellent professional relationships with clients, internal as well as external.

+ Manage the litigation services provided by all subcontracted defense attorneys and conduct comprehensive audits of litigated claim files.

+ Monitor excess insurance coverages and reserves on a continuous basis.

+ Provide direction to claims staff (insurance brokers and carriers) to ensure compliance with Claims Service Standards as well as continuously refining and improving claims handling procedures for UPMC's Corporate & Captive Insurance Program.

+ Work with President to develop, assign, and carefully monitor reserves for each claim.

+ Coordinate and conduct regular claim reviews with internal and external staff/clients/defense attorneys.

+ Associate's degree in Business, Communications, or a related field and 5 years of claims management experience dealing with indemnity claims OR Bachelor's degree in Business, Communications, or a related field and 3 years of claims management experience dealing with indemnity claims.

+ Extensive technical knowledge of claims management and settlements required. Excellent negotiating skills. Excellent interpersonal skills. Leadership abilities.

+ Excellent written and verbal communication skills. Ability to communicate clearly via telephone. Good personal computer skills.Licensure, Certifications, and Clearances:UPMC is an Equal Opportunity Employer/Disability/Veteran

About the Company

UPMC

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