Claim Operations Analyst - Eastern Alliance

• →40% - Complete accurate information on claim documents and ensure proper mailing in accordance with regulatory requirements and Company procedures; Complete accurate information according to state specific EDI trigger guidelines. Analyze data and fix errors/rejections returned from individual jurisdictions.  
• →35% - Enter accurate data into the computer system to make accurate indemnity and expense transactions as approved and directed by the claims representative daily. 
• →10% - Assist Claim Representative through the accurate completion of wage statements and calculation of partial compensation.
• →5% - Respond to telephone inquiries from agents, customers, injured workers, and providers in a professional, courteous and timely manner, providing high levels of customer service at all times. 
• →5% - Participate in department meetings as needed; provide general office support through copying and faxing documents.  
• →5% - Other special projects as assigned.

• High school diploma or GED required with a minimum two years of insurance or related experience is required. An associate’s degree is preferred. A bachelor’s degree may substitute insurance experience. 
• Proficiency in Microsoft Office computer applications; ability to learn new computer software applications. 
• Analytical ability, to analyze and interpret information; request more information when needed; and make appropriate decisions regarding a course of action.
• Attention to detail in processing all information, establishing priorities and meeting deadlines.
• Solid analytical and problem-solving skills, including formulating logical and objective conclusions. 
• Ability to assess the urgency and importance of a situation and take appropriate action.  
• Ability to communicate effectively and professionally both verbally and in writing with various constituencies and at all levels; both in and outside of the organization including agency partners, outside customers and clients. 
• Ability to operate standard office equipment including, but not limited to, copiers, fax machines, etc. 
• Ability to maintain confidential information. 

#LI-Hybrid

We are committed to providing a dynamic and inclusive environment where everyone can do their best work and grow personally and professionally.

For that reason, we partner with The Predictive Index (PI) – an organization equally committed to improving the working lives of people, to help us hire the best talent by providing additional insight about one’s work style. 

The position you applied to requires completion of two assessments prior to being scheduled to interview with a hiring manager. A Talent Acquisition team member may review your application and contact you before the assessment is complete. These assessments are Behavioral and Cognitive, and each assessment takes less than 12 minutes to complete.

After submitting your application, you will receive two emails from The Predictive Index inviting you to complete each of these assessments (please check your SPAM or Junk email folder if you do not see these emails in your inbox).

Note: If you already completed the assessments as part of an application with us, we may have results on file and you may not receive the emails inviting you to take the assessments. If you are moving forward in the process, a Talent Acquisition team member will confirm if we already have your assessment results.