What are the responsibilities and job description for the claims Analyst position at Acrisure?
Job Title: Claims analyst
Department: Claims
Location: Springfield, IL
About Acrisure
A global fintech leader, Acrisure empowers millions of ambitious businesses and individuals with the right solutions. Bringing cutting-edge technology and top-tier human support together, it connects clients with customized solutions across a range of insurance, reinsurance, payroll, benefits, cybersecurity, mortgage services and more.
In the last eleven years, Acrisure has grown in revenue from $38 million to almost $5 billion and employs over 19,000 colleagues in 21 countries. Our culture is defined by our entrepreneurial spirit and all that comes with it: innovation, client centricity and an indomitable will to win.
Essential Functions
To Executive Search Firms & Staffing Agencies: Acrisure does not accept unsolicited resumes from any agencies that have not signed a mutual service agreement. All unsolicited resumes will be considered Acrisure’s property, and Acrisure will not be obligated to pay a referral fee. This includes resumes submitted directly to Hiring Managers without contacting Acrisure’s Human Resources Talent Department.
Department: Claims
Location: Springfield, IL
About Acrisure
A global fintech leader, Acrisure empowers millions of ambitious businesses and individuals with the right solutions. Bringing cutting-edge technology and top-tier human support together, it connects clients with customized solutions across a range of insurance, reinsurance, payroll, benefits, cybersecurity, mortgage services and more.
In the last eleven years, Acrisure has grown in revenue from $38 million to almost $5 billion and employs over 19,000 colleagues in 21 countries. Our culture is defined by our entrepreneurial spirit and all that comes with it: innovation, client centricity and an indomitable will to win.
Essential Functions
- Receives lost time assignments. Verifies and determines applicability of coverage. Completes 24 hour contact with employer, employee and attending physician inclusive of telephonic contact, recorded statements and/or in person interviews with insured, employee, physician, and witnesses.
- Reviews all coverage issues and determines compensability within Midwest standards.
- Aggressively manages all aspects of the workers’ compensation claims management process inclusive of litigation, and providing direction to defense counsel.
- Responsible for customer relations management, consistently establishing and maintaining high levels of trust and confidence with clients, through constant contacts, prompt response and resolving client’s questions and claim issues.
- Responsible for setting of reserves to Ultimate Probable Cost (UPC). Sets reserves for anticipated exposure subject to authority limits.
- Addresses timely benefit delivery including production of benefit notices to the injured party as required in the applicable jurisdiction.
- Coordinates return to work (RTW) in accordance with the medical disability plan for the injured worker.
- Negotiates settlements directly with the injured worker or opposing counsel.
- Considers Medicare’s interests related to Conditional payments and injured workers eligibility and settlements.
- Recognizes and manages 3rd party liability and subrogation through recovery.
- Reviews medical and expense bills for causal relationship and bill charges over $1500.00.
- Consults with Claim Supervisor/Claims Manager/Executive claims on files where assistance and consultation are needed.
- Completion of Claim Status reports.
- Makes assignments to nurse case management when indicated, monitoring their billing and performance.
- Coordinate claim review meetings with both internal and external parties.
- Attend hearings and depositions when required.
- All other duties as assigned
- Professional telephone demeanor, good verbal and written communication skills, good listening skills, along with strong organizational skills.
- Thorough knowledge of workers’ compensation claims procedures and policies.
- Possess a strong understanding of human nature and motivation principles.
- Readily control/handle problem issues in times of stress and in a climate of conflict and/or adversity.
- Computer literacy including strong familiarity with Microsoft Office Suite. Ability to type 45 WPM.
- Basic understanding of business technology.
- Responsiveness to changing business needs.
- Ability to work well under pressure and multi-task in a fast paced environment while continually paying attention to detail.
- Ability to adhere to the code of ethical conduct and engage in fair claims settlement practices.
- Ability to take direction and make decisions.
- Ability to learn new procedures quickly and adapt to a changing environment.
- Ability to work in a team environment.
- Ability to work with limited supervision
- Minimum Education: High School diploma or Bachelor’s degree and/or 2-5 years similar experience is required.
- Litigation experience is preferred but not required.
- Prefer relevant state licensing or ability to gain licensing is required.
To Executive Search Firms & Staffing Agencies: Acrisure does not accept unsolicited resumes from any agencies that have not signed a mutual service agreement. All unsolicited resumes will be considered Acrisure’s property, and Acrisure will not be obligated to pay a referral fee. This includes resumes submitted directly to Hiring Managers without contacting Acrisure’s Human Resources Talent Department.
