Claim Operations Analyst - Eastern Alliance

ProAssurance Group Services Corporation; Lancaster (Lancaster County); Hybrid; USD 23,000 - 38,000; Full time

Job summary

ProAssurance Group Services Corporation in Lancaster, PA is seeking a Claims Support professional to join our team hybrid 2-4 days per month in Lancaster. The role focuses on delivering high quality customer service to the Claims Department while ensuring regulatory timeframes and accurate EDI handling across jurisdictions.

Ideal candidates have a High school diploma or GED, experience in insurance, proficiency with Microsoft Office, strong analytical and communication skills, and the ability to

Qualifications

• High school diploma or GED; 2+ years in insurance or related industry.
• Proficiency with Microsoft Office; ability to learn new software.
• Strong analytical and problem-solving skills with attention to detail.
• Effective written and verbal communication with diverse groups.
• Ability to handle confidential information.

Responsibilities

• Process claim documents and ensure regulatory compliance.
• Enter data into claims system for indemnity and expenses daily.
• Assist wage statements and partial compensation calculations.
• Respond to inquiries from agents, customers, injured workers, and providers.
• Participate in department meetings and provide general office support.
• Support special projects as assigned.

Skills

MS Office

Attention to detail

Analytical thinking

Communication skills

Insurance industry experience

Time management

Confidentiality

Problem solving

Ability to learn new software

Education

High school diploma or GED

Associate's degree preferred

Bachelor's degree may substitute insurance experience

Tools

Microsoft Office

Job description

An exciting opportunity exists to join the ProAssurance family of companies!

Our mission is powerful and simple: We protect others. Choosing a place to apply your talents is an important decision for anyone. You have plenty of options. Why choose ProAssurance?

At ProAssurance, we sell a pledge, and that pledge is delivered by our team members. We are seeking individuals who value integrity, leadership, relationships, and enthusiasm-and want to build their career with a great company where they can be their authentic self and feel valued, recognized, and rewarded for their contributions. ProAssurance specializes in healthcare professional liability, products liability for medical technology and life sciences, legal professional liability, and workers' compensation insurance. We are an industry-leading specialty insurer, with job opportunities in much of the contiguous United States.

This position supports our workers' compensation line of business, Eastern Alliance, and is hybrid, reporting to the Lancaster PA office 2-4 days per month.

The primary responsibility of this position is to provide technical support to the Claims Department to deliver superior levels of customer service and ensure the compliance with regulatory timeframes and other requirements in support of the Company's revenue and profitability objectives and overall business plan. The role also includes the ability to understand EDI transactions according to specific jurisdictional guidelines.

What you'll do:

• 40% - Complete accurate information on claim documents and ensure proper mailing in accordance with regulatory requirements and Company procedures; Complete accurate information according to state specific EDI trigger guidelines. Analyze data and fix errors/rejections returned from individual jurisdictions.
• 35% - Enter accurate data into the computer system to make accurate indemnity and expense transactions as approved and directed by the claims representative daily.
• 10% - Assist Claim Representative through the accurate completion of wage statements and calculation of partial compensation.
• 5% - Respond to telephone inquiries from agents, customers, injured workers, and providers in a professional, courteous and timely manner, providing high levels of customer service at all times.
• 5% - Participate in department meetings as needed; provide general office support through copying and faxing documents.
• 5% - Other special projects as assigned.

What we're looking for:

• High school diploma or GED required with a minimum two years of insurance or related experience is required. An associate's degree is preferred. A bachelor's degree may substitute insurance experience.
• Proficiency in Microsoft Office computer applications; ability to learn new computer software applications.
• Analytical ability, to analyze and interpret information; request more information when needed; and make appropriate decisions regarding a course of action.
• Attention to detail in processing all information, establishing priorities and meeting deadlines.
• Solid analytical and problem-solving skills, including formulating logical and objective conclusions.
• Ability to assess the urgency and importance of a situation and take appropriate action.
• Ability to communicate effectively and professionally both verbally and in writing with various constituencies and at all levels; both in and outside of the organization including agency partners, outside customers and clients.
• Ability to operate standard office equipment including, but not limited to, copiers, fax machines, etc.
• Ability to maintain confidential information.

#LI-Hybrid

We are committed to providing a dynamic and inclusive environment where everyone can do their best work and grow personally and professionally.

For that reason, we partner with The Predictive Index (PI) - an organization equally committed to improving the working lives of people, to help us hire the best talent by providing additional insight about one's work style.

Position Salary Range

$16.89 - $27.87 The salary range displayed represents the entirety of the pay g