
Claims Analyst Specialist
Há 5 dias
This role focuses on claims analysis, involving the evaluation of claim outcomes, analysis of unfavorable determinations, and advising on appeal strategies.
Key responsibilities include auditing and updating claim response templates for accuracy and effectiveness, communicating with clients to gather documentation, drafting and submitting responses to new claims, tracking claim outcomes and identifying trends, analyzing claim success rates, reporting on volume and outcomes to leadership, identifying opportunities to improve claim handling processes, advising clients on appeal options, filing appeals and confirming hearing schedules, analyzing appeal outcomes and identifying patterns, recommending improvements to appeal strategies, scheduling check-ins or coaching sessions with clients, sharing best practices and process improvement suggestions, evaluating client satisfaction and engagement, ensuring all submissions meet regulatory standards, and staying updated on changes in state agency requirements.
- Audit and update claim response templates for accuracy and effectiveness.
- Communicate with clients to gather information and provide guidance.
- Draft and submit responses to new claims.
- Track claim outcomes and identify trends.
- Analyze claim success rates.
- Report on volume and outcomes to leadership.
- Identify opportunities to improve claim handling processes.
- Advise clients on appeal options.
- File appeals and confirm hearing schedules.
- Analyze appeal outcomes and identify patterns.
- Recommend improvements to appeal strategies.
Additional skills and qualifications required:
- Experience in unemployment claims management industry.
- Experience working directly with clients to gather information and build long-term partnerships.
- Experience assessing claim outcomes, analyzing unfavorable determinations, and advising on appeal strategies.
- Experience using Bullhorn platform.
Benefits include a great compensation package and bonus plan, core benefits including full medical, dental, vision, and matching 401K, fully remote environment, flexible time off including volunteer time off, vacation, sick and 12-paid holidays.
Our company is proud to be an Equal Opportunity and Affirmative Action employer. Innovation is an important part of our DNA and practices, and our diverse workforce drives our success. Everyone can succeed at our company and bring their whole self to work, irrespective of their gender, ethnicity, religion, color, sexuality, physical ability or age.
What We OfferAs a member of our team, you will have the opportunity to collaborate with fellow team members, peers, and important partners, build relationships, and connect ideas across internal and external opportunities.
We invest in people and new advanced technologies to unlock the power of data.
Experian's culture and people are important differentiators. We take our people agenda very seriously and focus on what matters; DEI, work/life balance, development, authenticity, collaboration, wellness, reward and recognition, volunteering... the list goes on.
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