Claims & Insurance Analyst Sr.

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.
• Aid 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 insureds 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.
• Cook up 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.

Requirements

• 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.

Qualifications

• Licensure, Certifications, and Clearances: UPMC is an Equal Opportunity Employer/Disability/Veteran