Associate Claims Analyst

OMS NATIONAL INSURANCE CO; Schaumburg (IL); Hybrid; USD 58,000 - 70,000; Full time

Benefits offered by this job

Hybrid schedule

Tuition assistance

Long-term incentive plan

Paid Time Off

Health benefits

Job summary

OMS National Insurance Co. is seeking an Associate Claims Analyst to support the Claims department after incidents are reported, ensuring timely communication with insureds about potential claims. Responsibilities include investigation, evaluation, and resolution with a focus on pre-litigation claims.

The role involves reviewing medical records, preparing case summaries, and coordinating with attorneys, with a hybrid work schedule and comprehensive benefits offered.

Qualifications

• Bachelor’s Degree required; might accept equivalent professional experience.
• 1-2 years in legal, insurance, medical, or claims management field preferred.
• Proven relationship management expertise and working understanding of medical records.

Responsibilities

• Conduct claim investigations including assessment of policy coverage, liability, causation and damages.
• Communicate with insureds, claimants and attorneys regarding claim status and resolution.
• Assist insureds with inquiries prior to or in lieu of formal claim handling.
• Timely and accurate claim file documentation.
• Review medical and dental records to evaluate claims.
• Prepare case summaries and present claims for committee meetings.
• Set indemnity and expense reserves.
• Prepare settlement authority requests and conduct negotiations when appropriate.

Skills

Communication skills

Relationship mgmt

Analytical thinking

Multitasking

Negotiation

Education

Bachelor’s Degree

Tools

Microsoft Office Suite

Job description

Job Description

Job Description

At OMS National Insurance Co., our mission is simple. We are dedicated to serving and protecting oral and maxillofacial surgeons and dental professionals nationwide. If you wish to be part of a growing, well-respected industry leader, OMSNIC could be the right place for you.

We offer a robust array of benefits to support our employees- generous PTO, long-term incentive plan, affordable and comprehensive benefits plans, a hybrid work schedule, tuition assistance, and opportunities to advance your career. What makes us special is our collaborative culture and the impact we make as a team.

POSITION SUMMARY:

The Associate Claims Analyst plays a crucial role within the Claims department by responding to insureds after an incident has been reported, providing timely and clear communication regarding their potential claim. Additionally, the analyst is responsible for the investigation, evaluation, and resolution of claims, with a primary focus on pre-litigation claims.

ESSENTIAL DUTIES AND RESPONSIBILITIES :

• Conduct claim investigations including, but not limited to, assessment of policy coverage and evaluation of liability, causation, and damages, moving claims towards resolution
• Communication with insureds, claimants, and attorneys, including, but not limited to, timely communication regarding claim status and resolution
• Assist insureds with inquiries prior to/in lieu of formal claim handling
• Timely and accurate claim file documentation
• Review medical and dental records and supporting documentation to evaluate claims
• Prepare case summaries and present claims for committee meetings
• Set timely and reasonable indemnity and expense reserves
• Prepare settlement authority requests and conduct settlement negotiations, when appropriate

QUALIFICATIONS:

• Bachelor’s Degree required; might consider a demonstrated equivalent professional experience
• 1-2 years’ experience in the legal, insurance, medical, or claims management field, preferred. May consider educational background in lieu of related work experience
• Proven relationship management expertise
• Working understanding of medical records
• Microsoft Office Suite proficiency with emphasis on Word, Excel and PowerPoint

COMPETENCIES:

• Ability to productively interact with policyholders, legal professionals, external vendors, management, and board members
• Effective written and oral communication skills to provide information in a clear and concise manner and to communicate with variety of stakeholders
• Ability to multi-task in a fast-paced environment
• Strong critical thinking/problem solving skills
• Ability to assert position while communicating with empathy
• Effective analytical skills to gather information, analyze facts and make recommendations
• Ability to prepare robust reporting, as well as provide broad scope overview and summary
• Strong negotiation skills

PHYSICAL DEMANDS:

• Occasionally (several times a week) lifts, carries, or otherwise moves and positions objects weighing up to 10 pounds while fulfilling responsibilities
• Frequently sits for long periods at a time

WORK ENVIRONMENT:

• Performs work in an office environment (hybrid opportunity at manager’s discretion)

Salary : $ 58,000 to $70,000

Benefits:

• Medical, Dental, and Vision Insurance
• 401(k)
• Short and Long-term disability
• Life Insurance
• Employee Assistance Program
• Free onsite fitness center membership
• Long-term incentive plan
• Educational Assistance and rewards program
• Paid Time Off
• Paid Holidays
• Paid parental leave