Claim/Underwriting Analyst

Job Summary
The Claim/Underwriting Analyst is responsible for monitoring current and prospective clients, including: Collecting and evaluating aggregate claim reports from clients, processing reimbursable claims, maintaining data tracking records, preparing documents for prospects and group renewals and providing general customer service.  In addition, they will be provided training on the underwriting tools and processes so they gain proficiency in developing stop loss quotes.

Principal Duties and Responsibilities

• Reviews and processes all stop loss claims for payment.

• Maintains aggregate claim records and reports on current and renewal block of business.

• Gathers necessary RFP (Request For Proposal) data through broker or TPA necessary to generate a proposal.

• Assists in the development and preparation of proposals & renewals.

• Prepares initial stop loss quotes for prospects with assistance from the underwriting team.

• Develops and maintains relationships with key members of our TPA partners.

• Maintains confidentiality of all PHI in compliance with state and federal laws.

• Develops and maintains written standard procedures for all processes in their area of responsibility.

• Performs other duties as required

Qualifications

• Bachelor’s degree in business administration or related subject is preferred or equivalent work experience

• Working knowledge and proficiency in the use of computer and business related software, including Microsoft applications (Excel, Word and Outlook) and Adobe Acrobat.

• Working knowledge of various office equipment (computer, scanner, etc.)

• Proficiency in the use of the English language in reading, writing and speaking

• Proficiency in the use of business math

• Ability to successfully communicate with all organizational levels

• Ability to communicate clearly and politely via phone and email with plants, co-workers and vendors

• Ability to develop relationships with customers

• Ability to prioritize and organize workload with minimum supervision

• Ability to follow directions and instructions

• Ability to analyze and interpret data to develop recommendations and implement changes

• Ability to work hours mandated by management

• Ability to pass a drug test