Claim Operations Analyst - Eastern Alliance

CO1005 ProAssurance Group Services Corporation; Lancaster (Lancaster County); Hybrid; USD 23,000 - 38,000; Full time

Benefits offered by this job

Best-in-class benefits

Job summary

ProAssurance in Lancaster, PA, is seeking a Claims Support professional to provide technical support to the Claims Department and ensure regulatory timelines are met. The role includes processing claim documents, wage statements, and data entry, with hybrid work 2–4 days per month from the Lancaster office.

You will interact with agents, injured workers, providers, and internal teams, applying analytical skills, attention to detail, and confidentiality.

Qualifications

• High school diploma or GED required with a minimum two years of insurance or related experience.
• 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.

Responsibilities

• 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.

Skills

Analytical ability

Attention to detail

Communication

Problem-solving

Confidentiality

Time management

Education

High school diploma or GED

Associate 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 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. The position you applied to requires completion of two assessments prior to being scheduled to interview with a hiring manager. A Talent Acquisition team member may review your application and contact you before the assessment is complete. These assessments are Behavioral and Cognitive, and each assessment takes less than 12 minutes to complete. After submitting your application, you will receive two emails from The Predictive Index inviting you to complete each of these assessments (please check your SPAM or Junk email folder if you do not see these emails in your inbox). Note: If you already completed the assessments as part of an application with us, we may have results on file and you may not receive the emails inviting you to take the assessments. If you are moving forward in the process, a Talent Acquisition team member will confirm if we already have your assessment results.

Position Salary Range $16.89 - $27.87 The salary range displayed represents the entirety of the pay grade for this position. Most candidates will start in the bottom half of the range. Factors that may be used to determine your actual salary include your specific skills, how many years of experience you have, your location and comparison to other team members already in this role.

Build your career with us and enjoy access to a best-in-class benefits program. ProAssurance's family of companies has a unique and unwavering focus on our team members. We strive to achieve best-in-the-world status by attracting, hiring, and retaining top industry talent. We work together within our integrated family of companies, no matter the line of business, department or location. We ask, listen and respond to what matters most to team members. We thank you for your interest in career opportunities with ProAssurance!