837 Claims Analyst jobs in the United States

The Claims Analyst is responsible for monitoring the claims process and directing the work flow in the Claims Department. This position serves as the subject matter expert for their team updates written procedures, analyzes loans for financial recovery, and assists staff with complex cases, plans for sub-servicing transfers, reviews departmental performance and assists with departmental meetings.

Responsibilities:

• Monitors Investor/Insurer timeline requirements for additional recovery review
• Assists in training team members on the claims process and procedures
• Reviews department performance; assists with regular department meetings
• Adheres to FHA, VA, PMI, investor, insurer and master servicer guidelines, rules and regulations, as well as local/federal laws
• Manages conveyances and claims; analyze loans for final reconciliation; oversee filing of supplemental claims
• Manages and monitors performance of vendors; makes recommendations for change as needed; monitors and reviews vendor payments timely
• Identifies opportunities for cost and risk reduction, efficiency gains, and enhanced levels of service
• Analyzes trends in team work product to identify and implement process improvement
• Performs ongoing monitoring of key indicators to detect and research unexplained variances which may be indicative of quality control issues
• Interprets regulatory requirements and investor guidelines to identify opportunities, and manage a tracking and reporting mechanism to periodically communicate results
• Develops best practices to resolve deficiencies and meet regulatory compliance
• Remains current on policy and regulatory changes to maintain subject matter expertise
• Where quality control deficiencies arise, helps assess root causes, corrective actions needed, accountable parties, and corrective action timelines by working directly with senior leadership and business control management
• Creates reporting strategies to support management; tracks department activity for government portfolio and provides daily/monthly reporting to management and clients
• Works with Risk Management department in providing all required data for analysis
• Develops and maintain quality procedures and measures for the government portfolio to ensure appropriate documentation is in place
• Assists the team by filing Claims when necessary
• Appropriately assess risk when business decisions are made, including but not limited to compliance and operational risk. Demonstrate consideration for Cenlar's reputation as well as our clients, by driving compliance with applicable laws, rules and regulations, adhering to Policy, applying sound ethical judgment regarding personal behavior, conduct and business practices, and escalating, managing and reporting control issues, as well as effectively supervise the activity of others and create accountability with those who fail to maintain these standards

Qualifications:

• Bachelor's degree or equivalent experience
• 5 years related mortgage banking experience, quality assurance/control, auditing or other relevant experience
• 3 years knowledge of Investor/Insurer default servicing guidelines preferred
• Knowledge of sound risk management practices for mortgage servicing functions and demonstrated understanding of risk management and internal control principles
• Experience reviewing processes, reports, or documents with a strong attention to detail
• Experience interpreting rules and guidelines for appropriate decision-making
• Experience with issue resolution and group facilitation
• Functional understanding of loan servicing, including government-sponsored entity servicing requirements
• Strong analytical skills
• Self-motivated with ability to work under timelines without direct supervision
• Ability to work effectively without close supervision and be a self-starter
• A focus on delivery with meticulous attention to detail
• Excellent written and verbal communication and presentation skills for all levels, including senior management

Claims Analyst needed for full-time position offering hybrid flexibility after training, amazing benefits package, career advancement opportunity, a work environment that's supportive and team oriented and much more! In this role you'll be responsible for assuring accurate adjudication, refunds, and adjustments of claims by reviewing, researching, and/or returning suspended claims in accordance with the appropriate departmental processes. To be successful in this role candidates will need prior Claims and Coding experience, strong attention to detail and the ability to follow strict guidelines, as well as proficient computer skills in MS Word & Excel.

Requirements:

- Ability to work in office 8am-4pm M-F for training and as needed. Hybrid flexibility after training allows employees to work remotely 2days per week.
- 1+yr Claims, Medical Billing, Medical Coding, Health Insurance or similar experience
- Excellent attention to detail and time management skills
- Computer skills: MS Word & Excel; EHR/EMR and Claims Software a Plus

Job Opportunity At Starr Insurance Companies

Starr Insurance Companies is a leading insurance and investment organization, providing commercial property and casualty insurance, including travel and accident coverage, to almost every imaginable business and industry in virtually every part of the world. Cornelius Vander Starr established his first insurance company in Shanghai, China in 1919. Today, we are one of the world's fastest growing insurance organizations, capable of writing in 128 countries on 6 continents.

Location: Atlanta, GA

Employment Type: Full time

Job Requisition ID: JR3052

Daily Responsibilities:

• File creation and maintenance
• Coverage analysis and determination
• Liability and damages investigation and evaluation
• Help prepare various reports as required
• Follow up on information needed from brokers, adjusters, underwriters and insureds
• Developing presentations and marketing material
• Other duties as directed by the department manager

Additional Job Duties:

• Obtain all state insurance adjuster licenses
• Obtain the AIC (Associate in Claims) or other insurance designation

Requirements:

• B.A. or B.S. degree from an accredited university
• 5 years aviation claims handling experience preferred
• Pilot's license and/or A&P preferred
• Strong verbal, written and interpersonal skills
• Advanced proficiency in computer applications: Excel, Word and PowerPoint, Databases
• Leadership skills
• Strong organizational and time management skills with the ability to multi task/prioritize
• A self-starter and entrepreneurial mindset

Starr is an equal opportunity employer, which means we'll consider all suitably qualified applicants regardless of gender identity or expression, ethnic origin, nationality, religion or beliefs, age, sexual orientation, disability status or any other protected characteristic. We recruit and develop our people based on merit and we're committed to creating an inclusive environment for all employees. We offer first class training and development opportunities to all employees. Our aim is to grow our own talent and bring out the best in people.

Job Description

American Amicable is seeking a Claims Analyst to join our Claims team! The Claims Analyst processes life, disability, and waiver of premium claims; answers questions and provides customer assistance to all policyholders/agents and funeral homes regarding policy and claim status via telephone, e-mail, or fax.

Your Day to Day

• Processes and pays claims within established guidelines. Includes determination of in-force coverage, obtaining the necessary requirements through telephone and written contacts, verifying completeness, calculation of the actual benefits payable to include calculations of death benefits, interest, dividends, premium variances, fund interest, etc.
• Prepares letters and updates claims system for ready to process claims.
• Conducts research on beneficiaries, physician's records, medical facilities, legal documents, and other important data needed to make claims decisions.
• Processes paid incontestable claims including correspondence, accounting and file maintenance.
• Approves claims with a payout of $20,000 or less during a probationary period, then release for higher claim amounts based on performance.
• Files and processes reinsurance when applicable.
• Prepares and mails IRS Form 712.
• Monitors suspense accounts
• Records and maintains information for year-end tax reporting.
• Cross-trains with Claims Analysts to be able to support various tasks and duties in the absence of coworkers.
• Communicates with customers through inbound and outbound phone calls, written correspondence and e-mail to ensure successful claim processing.
• Keeps records of customer interactions, recording details of inquiries, complaints, and comments, as well as actions taken.
• Maintains a familiarity with the details of Company products and policies, and a working knowledge of where to get assistance in responding to inquiries. Participates in special projects and assignments.
• Assists with incoming telephone calls and work overflow for various Claims functions.

What You Have

• High school diploma or general education degree (GED).
• Proficiency as a Senior Claims Specialist; normally demonstrated though 2 years of Claims experience.
• Life claims experience preferred but not required.
• Ability to type a minimum of 35 wpm.

We Offer

• Competitive Benefits (Medical, Dental, Vision, Short- and Long-Term Disability, 401K w/ match, PTO, and more!)
• A Human Approach
• Career Advancement
• Professional Development Opportunities

#LI-BW

Applicants must be authorized to work for any employer in the U.S. We are unable to support or take over sponsorship of employment visas at this time, including H-1B visas and participation in STEM OPT work authorizations.

Company
American-Amicable Life Insurance Company of Texas

Posting End Date


About us

American Amicable is a part of iA Financial Group, one of the largest insurance and wealth management groups in North America. Our headquarters is in Waco, TX. Tracing its roots back to 1910, the American-Amicable Life Insurance Company of Texas is a progressive special markets insurer. The Company offers innovative life insurance and annuity products developed to target the individual needs of protection, wealth creation, and estate preservation.

iA Financial Group is the fourth largest life and health insurance company in Canada and offers a wide range of products for all stages of life and to meet the needs of clients across its vast sales network. Founded in 1892, iA Financial Group's stability and solidity make it an employer of choice that invests in its employees and their development over the long term. Our CEO Denis Ricard won #1 Insurance CEO in Canada from Glassdoor!

Our Commitment to Diversity and Inclusion

At iA American, we support and celebrate diversity. We strive to provide a workplace that is recognized as inclusive for all, regardless of ethnic origin, nationality, language, religious beliefs, gender, sexual orientation, age, marital status, family situation, or physical or mental disability.

Please note that if you need help or assistance to make the recruitment process more accessible for you, please contact us. Someone from our team will be happy to assist you.

Build Your Career Where You Matter
Join The Cook & Boardman Group, the nation's leading provider of architectural doors, frames, hardware, specialty products, and complete security integration services.

At The Cook & Boardman Group, trust and communication are the foundation of how we work. We foster an inclusive, collaborative culture where your voice is heard, your ideas matter, and your career has room to grow. Whether you're a problem-solver, innovator, or passionate about service, you'll thrive here.

Why Work With Us?
We're committed to your success, personally and professionally. You'll have access to:

• Comprehensive Benefits: Health, dental, vision, prescription coverage, life insurance, and 401(k) with company match.
• Work-Life Balance: Generous paid time off for rest, family, and self-care.
• Career Growth: You'll benefit from continuous learning, mentorship, and leadership training including access to C&B University, our in-house development program.
• Supportive Culture: Innovation, creativity, and teamwork are at the heart of everything we do.

Be part of a team that invests in your future, celebrates your success, and values your contribution.

The Claims Analyst supports the Company's Insurance and Bonding function by managing and analyzing claims data, assisting employees through the claims process, and maintaining accurate records. This role also provides backup support for bond processing and assists with various insurance-related administrative tasks. The ideal candidate has strong analytical and communication skills, attention to detail, and experience working with insurance claims in a fast-paced, construction-focused environment.

The is a Part-Time role located in the United States.

Key Responsibilities:

Claims Management
• Collect and analyze data related to accidents and incidents involving company personnel, vehicles, or property
• File and track insurance claims in coordination with third-party administrators or insurance carriers
• Serve as a point of contact for employees regarding the claims process, providing guidance and support as needed
• Monitor claim activity and identify trends to support proactive risk management and loss control
• Maintain organized and accurate records of all claims and related correspondence
Bonding Support
• Provide assistance with subcontractor bond processing when the Manager of Insurance and Bonds is out of the office
• Ensure timely and accurate completion of bonding documentation and records
General Insurance Support
• Assist the Manager of Insurance and Bonds with miscellaneous administrative and operational insurance tasks
• Help gather data or documentation required for audits, renewals, or risk evaluations
• Support internal compliance initiatives related to insurance and bonding requirements

Qualifications:
• Associate's degree in Business, Risk Management, Insurance, or related field preferred
• 2+ years of experience in claims administration, insurance, or related field; experience in the construction industry a plus
• Familiarity with general liability, workers' compensation, auto, and property insurance policies
• Strong organizational and analytical skills
• Excellent written and verbal communication skills
• Proficient in Microsoft Office (Excel, Word, Outlook) and able to learn company systems quickly
• Ability to handle sensitive information with discretion

Physical Demands
The physical demands described here are representative of those required to successfully perform the essential functions of this position. While performing the duties of this role, the employee will regularly communicate verbally and in writing, and must be able to see and hear in a typical office setting. The role frequently involves sitting, walking, standing, using hands to handle or feel, and reaching with arms and hands.

Work Environment
This position operates primarily in a professional office environment. It routinely involves the use of standard office equipment such as computers, phones, printers, copiers, and filing systems. Occasional business travel may be required.

Qualification Requirements
To perform this job successfully, an individual must be able to carry out each essential duty satisfactorily. The requirements listed represent the knowledge, skills, and abilities necessary for success in the role. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Equal Opportunity Employer
The Cook & Boardman Group is an Equal Opportunity Employer and a VEVRAA Federal Contractor. We are committed to providing equal employment opportunities to all qualified individuals, including minorities, females, protected veterans, and individuals with disabilities. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

GENERAL DESCRIPTION OF WORK:

Investigates, processes and evaluates all third-party claims involving company vehicles, property and/or employees. Reviews all types of claim files for subrogation potential. Negotiates settlement of accident claims as assigned, including subrogation claims. Interprets and apply governmental statutes and immunities to claim files. Prepares general correspondence and claims data reports. Requires general supervision and direction. Must be able to negotiate and deal with attorneys and claimants in a clear and understanding manner. Performs fieldwork as required.

ESSENTIAL FUNCTIONS:

Investigates and adjusts claims. Responsible for processing vehicle/property damage, bodily injury and subrogation/collection files.

Participates in direct communication and negotiations with claimants, attorneys, and insurance adjusters.

Maintains regular contact with Human Resources, Transportation, and Fleet and Facilities Divisions for proper reports and investigation of claims.

Reviews written and recorded statements from witnesses and claimants.

Maintains accurate, up to date files, and adjusts reserves as necessary.

Prepares correspondence in reply to claimants, insurance adjusters, attorneys or other interested parties.

Compiles claim and reserve data and prepares reports.

Assists the Manager of Risk Management in all public liability matters, projects and special assignments.

Performs related duties and fulfills responsibilities as required.

This job description excludes marginal functions that are incidental to performing the job. Other duties may exist.

REQUIRED EDUCATION AND EXPERIENCE:

Associates degree and two (2) years' experience in adjusting bodily injury, property damage, or auto claims. Adjuster's license is required. Experience may be substituted in lieu of education on a year-for-year basis for up to two years.

PREFERRED QUALIFICATIONS:

Public entity experience.

ADDITIONAL REQUIREMENTS:

Must be able to communicate clearly and effectively, both verbally and in writing.

Must have working knowledge of applicable Federal and State statutes including the Texas Tort Claims Act.

Must have the ability to give oral or written presentations regarding claims.

Must be able to perform all phases of analytical work, using various computer programs, maps, schedules and other tracking applications.

Must have mathematical skills to perform basic calculations.

Must be able to analyze data, compile reports and provide trending data and analysis.

Must possess skill in using Microsoft office solutions applications.

Must have the ability to negotiate with claimants, attorneys, and insurance adjusters.

Must be able to multi-task and handle stressful situations.

Must have a good driving record, a valid driver's license, and have access to private transportation.

Bilingual skills preferred.

Must be able to maintain good work attendance.

Safety Accountability Statement:

- Employees must consider safety in all tasks performed, as well as demonstrate safe judgment and decisions that not only maintain their own safety; but that of fellow employees and customers.

- Demonstrate a professional commitment to assure compliance with all organizational policies, practices, and programs related to safety, health, and system security.

- Employees have a responsibility to identify and report hazards, as well as potentially unsafe conditions, to your immediate supervisor or Safety Department.

- Employees are responsible, and required, to stop a job/task to prevent an unsafe incident or act from occurring. This acknowledges the threat of potential injury, property damage and the opportunity for better judgment to be used.

Must comply with and support all applicable VIA EEO Policies and Procedures.

PHYSICAL REQUIREMENTS:

Physical ability required to be mobile, bend, stoop, stand, reach and lift objects weighing 5-25 pounds such as files, supplies, equipment and large heavy reference manuals and books.

WORK ENVIRONMENTS:

Works in normal office environment.

Perform field work as required.

Work hours may involve early mornings, late nights, and weekends.

Work involves deadlines and multiple priorities.

VIA is an Equal Employment Opportunity Employer, providing equal opportunity to all qualified individuals, regardless of race, color, religion, age, sex, national origin, veteran status, genetic information, or disability.

POSITION SUMMARY/RESPONSIBILITIES
Analyze complex problems pertaining to claim payments, eligibility, other insurance, transplants and system issues that are beyond the scope of claim examiners and senior claim examiners that affect claims payment. Act as consultant to claims staff in complex claim issue resolution. Work cooperatively with Configuration in testing of contracts used in business operations and reporting to ensure auto adjudication. Perform in accordance with company standards and policies. Promote harmonious relationships within own department, with other departments and within CFHP. Operate under limited supervision.

EDUCATION/EXPERIENCE
High school diploma or GED equivalent is required. Five years' HMO/PPO claims experience required. Amisys claims processing system experience preferred. Knowledgeable of all benefit programs offered by the CFHP, Medicaid, HMO, PPO, ASO.

Join Our Team as Claims Analyst at Stealth Partner Group, an Amwins Group Company!

Are you ready to make a meaningful impact in the dynamic world of insurance? Join Stealth Partner Group, an Amwins Group Company, as a Claims Analyst . This is an in-office position in Scottsdale, AZ that offers the flexibility to work from home up to 2 days a week after completing training.

Why Choose Amwins? At Amwins, we value our team members and offer a range of benefits to enhance your work experience:

• Flexibility: Enjoy a hybrid work environment with flexible scheduling options.
• Comprehensive Benefits: Access a competitive benefits package from day one, including generous Paid Time Off (PTO) and paid holidays.
• Continual Learning: Thrive in a collaborative, education-focused work environment.
• Annual Bonus Program: Earn rewards through our bonus program after just one year of employment.

Learn more about us at stealthpartnergroup.com and amwins.com.

Responsibilities:

As a Claims Analyst, you will:

• Learn Stealth's Business Model : Understand Stealth's business model and the products we support under the guidance of the Claims Manager and Lead Claims Auditor.
• Effective Correspondence : Correspond accurately and timely with carriers, administrators, clients, and brokers using approved form letters and emails, with all correspondence copied to the Claims Lead.
• Claim Reports Management : Manage monthly claim reports for the administration of the assigned book of business, ensuring forwarding to the appropriate carrier and following up on missing reports.
• Reimbursement Request Review : Review submitted reimbursement requests for completeness and request any missing information.
• Eligibility Documentation Approval : Obtain approval from the Claims Lead on eligibility documentation noting time-off exceeding twelve (12) weeks before submitting a claim reimbursement request.
• Claim Submission and Tracking : Record and submit reimbursement requests to the appropriate carrier within authorized dollar authority, tracking and following up on outstanding payments.
• Reimbursement Issuance : Review and issue reimbursements, notifying designated contacts accurately and in a timely manner.
• Claim Tracking Logs : Maintain internal claim tracking logs to ensure accurate records.
• Year-End Account Closure : Manage the settlement of all reimbursement requests at the end of the plan year to properly close the client's account.
• Adaptability and Team Collaboration : Handle other duties and projects as assigned, showcasing adaptability and strong collaboration skills.

Qualifications:

To excel in this role, you'll need:

• Education and Experience : A college degree or equivalent work experience is strongly preferred.
• Tech Proficiency : Proficiency with Microsoft Office products (Word, Excel, Outlook, and Teams) is preferred.
• Critical Thinking : The ability to critically think and problem-solve.
• Confidentiality : Ability to maintain strict confidentiality.
• Organizational Skills : Ability to multitask, adjust to changing priorities, and effectively manage time to meet deadlines.
• Communication Skills : Effective written and verbal communication skills with both internal and external parties.
• Attention to Detail and Urgency : A sense of urgency and attention to detail are necessities.
• Eager to Learn : Eagerness to learn Stealth's business model is a necessity.

The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities, or physical requirements. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Summary:

This key role is at the heart of what we do at Armada - pay our members claims! The Claims Analyst is responsible for reviewing portal entry claims, conducting error correction and quality control reviews, as well as final adjudication of paper and electronic claims. The ideal Claims Analyst will be analytical and have an interest in digging in to find the right answer, all while meeting our high excellence and service standards. They will have good communication skills and be comfortable working with high-profile clients.

Tasks/Responsibilities:

• Apply product, plan provisions, SOPs, benefit limits and policy exclusions to determine the next steps for a claim
• Process claims, including all associated tasks - benefit eligibility verification, determining the appropriateness of a claim, etc
• Acquire additional claims substantiation, as needed
• Complete related tasks such as claim identifications, member communication, and closing of said claims
• Use multiple systems and tools to answer service requests and inquiries received from various channels
• Research and resolve other general customer account inquiries as appropriate
• Review charges and use of payment or denial codes within established guidelines and standards
• Maintain records, files, and documentation
• Meet or exceed the standards of department production and quality
• Such other duties or tasks to assist the department of organization as the supervisor may deem necessary.

Skills/Requirements:

• Must be proficient in MS Word, Excel, and Outlook.
• Excellent verbal and written communication skills required
• Deeply analytical with the ability and interest to research and "solve the puzzle"
• Strong attention to detail and an eye for accuracy
• Must have a good command of the English language, oral, and written
• Must be able to work in a fast-paced environment with demonstrated ability to handle multiple tasks
• Ability to maintain confidentiality
• Ability to deal with difficult people and problems
• Able to work well in a team environment and with a diverse group of people
• Ability to work mandatory overtime during busy periods
• Ability to meet established carrier deadlines

Physical Demands:

• Ability to sit for long periods of time

Benefits:

• Medical, Dental, and Vision insurance
• Employer-sponsored Health Savings Account OR Employer-paid enrollment in an Armada supplemental insurance plan
• Flexible Spending Accounts (medical and dependent care)
• Employer-paid life insurance
• Employer-paid long-term disability insurance
• Short-term disability insurance
• 401(k) retirement plan with employer match
• Paid time off
• Eight paid holidays per year
• Free access to onsite gym at Hunt Valley office location
• Patient to Physician matching service
• Travel assistance program
• Employee Assistance Program (EAP)
• Employee referral bonus program - earn up to $1500 per hire
• Professional development opportunities
• Voluntary benefits and discount programs
• Hybrid work environment
• Company events
• Employer-sponsored philanthropy initiatives

Probationary Period:

This role will have a three (3) month probationary period during which time management will have an opportunity to determine whether a person is able to perform all required duties of employment. Details related to job expectations and production metrics will be provided by management.

Position is hybrid during new hire training period (in-office Tuesday - Thursday, remote Monday and Friday). Following the initial training period, the role will be primarily remote with the requirement to be in office Tuesday - Thursday during the second week of the month.
40+ hours per week. Overtime required during busy seasons.