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| Claims Casualty Analyst & Development Consultant |
Last Updated:
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Job Description:
This position reports to the Director of Claims Risk Management, Training and SIU.
*The Claims Casualty Analyst & Development Consultant is responsible for developing learning programs and for providing coaching related to the investigation, coverage application, liability evaluation and damages verification for both 1st Party UM/UIIMBI, PIP and Medical Payments claims and 3rd Party Liability claims.
*This position also serves as a resource person for the PIP unit and for Medicare Section III reporting compliance.
*Design and deliver in-person and web-based training content, procedural guidelines, individualized training and coaching plans, and web-based reference resources.
*Provide technical advice and consultation for complex claims handling practices, legal and claims principles, accurate reserving and loss control practices.
*Work closely with department Risk Managers to monitor and measure the effectiveness of training and to identify positive and negative trends and patterns in claims processing, and/or Adjuster performance.
Skills Required:
*Bachelor's degree or equivalent experience
*9-15+ years' extensive and specialized adjusting, management, Claims Examining/Litigation Analysis, and or related insurance experience.
*AIC, CPCU and other insurance industry designation(s)/certification(s) desirable.
*In depth familiarity with medical terminology and medical management resources, including bill review, records reviews and IMEs required.
*Advanced Level of expertise in Outlook, Excel, Word, PowerPoint and Internet research.
*Expert working knowledge of Property/Casualty insurance contracts, Fair Claims Practices Acts and regulatory compliance.
*Advanced, in-depth skills and ability to extract, compile and analyze data from studies and reports.
*Highly proficient organizational, interpersonal, written/verbal/listening communication skills.
*Ability to meet requirements for travel, after-hour, on-call, and weekend work as necessary.
*Demonstrated ability to successfully perform assignments independently and/or with a team.
***Relocation Package available***
Compensation:
72,209. - 90,474.
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