Claims Management Analyst

Northwell Health • New York, NY • 3h ago

Req Number 182655

Job Description

Analyzes, identifies and provides timely and accurate review and adjustment of claims. Supports administration of claims resultant from the organization insurance programs.

Job Responsibility

Analyzes, identifies and administers various property and casualty insurance claims including reporting and processing of claims.

Coordinates the administration of claims with insurance broker's claim department and Third Party Administrators (TPAs); liaises with other departments and facilities to gather claim related documentation for discovery and related investigations.

Participates in claim conferences; maintains electronic and hard copy claim files.

Gathers and analyzes claims data in support of preparing reports and presentations for management; maintains and reviews loss runs for assigned insurance lines to determine trends.

Coordinates with management and insurance team on insurance policy placement including, but not limited to analyzing claim trends.

Provides analysis of impact if any of change in insurance program; participates in renewal strategy meeting.

Provides input for risk minimization and loss control to management.

Coordinates with assigned defense counsel to ensure compliance with litigation and billing guidelines, and to facilitate effective and efficient litigation and resolution strategies.

Participates in site visits, as needed.

Operates under general guidance and work assignments are varied and require interpretation and independent decisions on course of action.

Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.

Serve as a liaison, facilitating communication and collaboration between internal stakeholders/departments and external vendors/partners to drive initiatives, program enhancements, and ensure effective service delivery.

Ensures timely follow-up on identified action items collaborating with internal departments and external partners to drive resolution and successful outcomes.

Assist in the development and maintenance of tracking systems and dashboards to monitor the progress of claims initiatives, strategic recommendations, and key performance indicators for the department.

Assist with projects aimed at enhancing vendor and partner operations, including defining scope, objectives, and deliverables.

Job Qualification

Bachelor's Degree required, or equivalent combination of education and related experience.

1-3 years of relevant experience, required.

*Additional Salary Detail

The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).

The salary range for this position is $66300.00-$98500.00/year

It is Northwell Health's policy to provide equal employment opportunity and treat all applicants and employees equally regardless of their age, race, creed/religion, color, national origin, immigration status or citizenship status, sexual orientation, military or veteran status, sex/gender, gender identity, gender expression, disability, pregnancy, genetic information or genetic predisposition or carrier status, marital or familial status, partnership status, victim of domestic violence, sexual or other reproductive health decisions, or other characteristics protected by applicable law.

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