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Claims Analyst
Clear Blue Insurance Services Puerto Rico
Charlotte, NC
Category
Finance
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Job Description
The Claims Analyst will utilize experience within commercial property and casualty claims to manage, monitor and assess complex claims activity of Third-Party Administrators (TPAs); use direct systems to access and monitor claim files, denials, reservations of rights, and settlements conducted by TPAs; ensure that the TPAs are performing within their authority, pursuant to agree upon processes and practices, within the agreed upon territories and market segments; ensure compliance with internal policies and regulations; consult with the Chief Risk Officer, Legal, Compliance, Finance, Underwriting, and IT departments to identify specific trends or problems within a program; keep records of all monitoring activity and report to the management team, support data-driven decision making with quantitative and qualitative measures and assessments.
Requirements
Bachelor’s degree in business, Finance, Risk Management, Insurance, or equivalent related experience
Three (3) to Five (5)+ years of experience in claims analysis or a related role, experience in claim handling, relevant litigation, or TPA management
Industry certifications (e.g., AIC) preferred
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