Complex Claims Analyst

Primary Purpose of the Role

To prospectively identify complex claims issues and complaints; to strategically triage referrals to the appropriate examiner or complex claims advisors for handling; or to independently handle and expedite resolution of less complex complaints and/or claim issues.

Essential Responsibilities

• Analyzes data to identify complex claims requiring further intervention through triaging internal referrals, complaints from regulatory agencies and external entities.
• Proactively and strategically triages complex claim issues or complaints; determines the most appropriate resource to resolve.
• Uses knowledge of all aspects of claims handling in evaluating the issue for expedited handling or assignment for continued handling.
• Articulates and documents clear and concise file notes to allow stakeholders to understand the issue evaluation and determination.
• Provides technical direction, feedback, and resolution on specified claims.
• Performs other duties as assigned.
• Supports the organization's quality program(s).

Qualifications

Education & Licensing: Five (5) years of liability claims experience or equivalent combination of experience and education required. Specific jurisdictional expertise preferred. Bachelor's degree from an accredited college or university preferred. Industry designation(s) preferred. Licenses as required for specific jurisdictions.

Skills & Knowledge

• Subject matter expertise in liability and transportation claims processing
• Ability to obtain and maintain appropriate licensing
• Ability to manage claims across multiple jurisdictions
• Excellent oral and written communication skills
• PC literate, including Microsoft Office products
• Strong analytical and interpretive skills
• Strong organizational skills
• Strong time management skills
• Excellent interpersonal skills
• Ability to work in a team environment
• Ability to meet or exceed Service Expectations

Work Environment Requirements

• Physical: Computer keyboarding
• Auditory/visual: Hearing, vision and talking
• Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.