TPA Claims Oversight & Analytics Analyst

ADP, Inc.; Charlotte (NC); On-site; USD 55,000 - 75,000; Full time

Job summary

ADP, Inc. in Charlotte, NC is seeking a Claims Analyst to monitor TPAs and assess claims activity for the program's performance. You will verify authority, analyze trends, and report findings to management to improve outcomes for stakeholders.

Responsibilities include auditing claims, coordinating with risk, legal, compliance, and underwriting teams, and providing proactive service to clients and partners. Some travel may be required.

Qualifications

• One to three years of experience in claim handling, quality assurance, relevant litigation, TPA management, or equivalent related experience.

Responsibilities

• Providing front-line oversight of TPAs’ personnel through direct communication and monitoring claims online using the TPAs’ claim systems.
• Identifying, analyzing, and discussing monthly loss run trends, reportable claims and/or problematic claims.
• Providing excellent claim service to external clients and internal partners.
• Participating in claim file reviews with agents, brokers and TPAs’ claim personnel.
• Interfacing with Clear Blue and external underwriting on claim status, exposures, and other factors impacting their risks.
• Preparing and presenting internal management reports for large losses and large loss potential; usually over $250,000.
• Conducting remote and onsite claim file audits of TPAs.
• Performing other duties as required by management including reinsurance and subrogation.
• Focus on monthly auditing of TPAs

Skills

Claims handling

Quality assurance

TPA management

Communication skills

Interpersonal skills

Time management

Education

Associate's or Bachelor's degree in insurance, finance, or risk management

Tools

Microsoft Office

Job description

ADP, Inc. in Charlotte, NC is seeking a Claims Analyst to monitor TPAs and assess claims activity for the program's performance. You will verify authority, analyze trends, and report findings to management to improve outcomes for stakeholders.

Responsibilities include auditing claims, coordinating with risk, legal, compliance, and underwriting teams, and providing proactive service to clients and partners. Some travel may be required.