Senior Claims & Insurance Analyst

UPMC Senior Communities • $75K — $95K *
Pittsburgh, PA 15237In-Person
Finance & Insurance
Less than 5 years of experience
3 weeks ago
Job Overview by Ladders

Qualifications

  • Associate's degree in business, Communications, or related field with 5 years of claims management experience, or a bachelor's degree with 3 years of experience.
  • Extensive technical knowledge of claims management and settlements.
  • Strong negotiating skills for effective claim resolutions.
  • Excellent interpersonal and communication skills, both written and verbal.
  • Demonstrated leadership abilities to guide claims staff effectively.
  • Proficiency in personal computer usage for claims database management.

Responsibilities

  • Negotiate cost-effective settlements within designated financial authority or prepare for executive review.
  • Complete special projects and support daily Risk Management initiatives as directed by leadership.
  • Represent UPMC in communication on legal aspects of claims with commercial insurers and defense firms.
  • Assist in managing all claims activities for commercial lines of coverage.
  • Prepare and issue reservation of rights letters and coordinate documentation with insurers.
  • Review daily correspondence and maintain a comprehensive claims database.
  • Evaluate and coordinate legal counsel assignments on cases for effective representation.
  • Analyze complex employee-related claims submitted under UPMC Captive policies.
  • Prepare legal correspondence for insureds and maintain professional client relationships.
  • Audit litigated claim files and manage subcontracted defense attorney services.

Benefits

  • Hybrid work schedule with opportunities for onsite and remote work.
  • Engagement in complex and impactful claims management work within a reputable institution.
  • Involvement in Risk Management initiatives that shape the future of claims handling.
  • Professional development through interaction with high-level executives and experienced attorneys.
  • Supportive work environment fostering teamwork and collaboration.
Full Job Description
This role will work Monday through Friday during standard business hours. The Analyst will have the ability to work a hybrid schedule with onsite requirements and work from home.

This role manages complex claims involving primary and excess insurance coverages, significant litigation, and extensive liability; monitors claims work on complicated claims; assumes responsibility for reviewing claims for settlement potential; managing the litigation services provided by all subcontracted defense attorneys; and conducts comprehensive audits of litigated files.

Do you have prior experience with auto and or property claims? If so, this could be the next step in your career. Apply today!

Responsibilities:

  • Identify and negotiate cost effective claim resolutions/settlements up to designated financial authority or prepare for review/approval by President.
  • Complete special projects and contribute to daily Risk Management Initiatives as directed by the President or Director.
  • Serve as the representative of UPMC Corporate & Captive in regard to communicating all legal aspects of claims activity between UPMC and the various commercial insurers and their respective defense firms.
  • Assist the Director of Corporate & Captive Insurance (Director) with administrating all commercial lines of coverage, including all claims activities associated with the various UPMC commercial policies.
  • Assist the President and Director of annual policy review of each individual insurance policy written through UPMC Captive Insurance Program.
  • Prepare and issue all reservation of rights letters on behalf of UPMC Captive Insurance Program, including submitting and coordinating all necessary documentation to commercial carriers of potential and filed lawsuits.
  • Review daily correspondence to maintain comprehensive claims database with settlements, dismissals, demands, financial reserves and trial dates.
  • Work with the President, Captive Insurance Program & Counsel (President) to evaluate and coordinate in-house and external counsel assignments for each case.
  • Analyze complex, technically challenging, and/or sensitive employee related and third party claims that are submitted for coverage under one of, but not limited to, UPMC Captive policies; Directors & Officers Liability, including Employment Practice Liability, Managed Care Errors & Omissions, General Liability and Professional (malpractice) liability.
  • Prepare all legal correspondence to all program insured(s) and attorneys.
  • Field a wide variety of phone calls/emails from insureds regarding insurance coverage and claims questions and what to expect during the legal discovery process.
  • Coordinate and prepare all necessary information for review by President.
  • Maintain excellent professional relationships with clients, internal as well as external.
  • Manage the litigation services provided by all subcontracted defense attorneys and conduct comprehensive audits of litigated claim files.
  • Monitor excess insurance coverages and reserves on a continuous basis.
  • Provide direction to claims staff (insurance brokers and carriers) to ensure compliance with Claims Service Standards as well as continuously refining and improving claims handling procedures for UPMC's Corporate & Captive Insurance Program.
  • Work with President to develop, assign, and carefully monitor reserves for each claim.
  • Coordinate and conduct regular claim reviews with internal and external staff/clients/defense attorneys.


Qualifications:

  • Associate's degree in business, Communications, or a related field and five years of claims management experience dealing with indemnity claims
    • OR bachelor's degree in business, Communications, or a related field and three years of claims management experience dealing with indemnity claims.
  • Extensive technical knowledge of claims management and settlements required.
  • Excellent negotiating skills.
  • Excellent interpersonal skills.
  • Leadership abilities.
  • Excellent written and verbal communication skills.
  • Ability to communicate clearly via telephone.
  • Good personal computer skills.

    Licensure, Certifications, and Clearances:
  • Act 34

About UPMC Senior Communities

UPMC Senior Communities Careers

There has never been a better time to explore the diverse job opportunities at UPMC Senior Communities—the leading network of senior living facilities focused on innovative care and professional excellence.

Work You’ll Do

Join UPMC Senior Communities to assist in transforming the experience of aging through top-tier care and wellness programs. This is an opportunity to be part of a team that values leadership, diversity, and innovation in the healthcare sector. Lead in a unique role where skills in healthcare, empathy, and leadership converge to enhance the lives of seniors. UPMC Senior Communities stands at the forefront of the industry, integrating advanced technology and personalized care practices. Engage with a professional network of healthcare providers and administrators dedicated to pioneering improvements in senior living. Collaborate with over 3,000 dedicated professionals across various facilities.

Introducing the UPMC Senior Communities Professional Development Program

The program is designed to foster career growth through comprehensive training, leadership development, and diversity training. UPMC Senior Communities is committed to nurturing the professional growth of its team members through continuous education and opportunities for advancement.

Do Innovative Work

Be part of a culture that thrives on innovation and continuous improvement. UPMC Senior Communities employs a vast array of healthcare professionals and support staff, all dedicated to setting new standards in senior care.

Drive Change in Senior Healthcare

Deliver targeted solutions and personalized care that significantly improve the quality of life for residents. UPMC Senior Communities offers a platform for professionals to apply their expertise in a meaningful and impactful way.

Be Part of a Great Team

Work alongside a team that values compassion and professionalism, harnessing the collective capabilities to deliver exceptional care. UPMC Senior Communities promotes a collaborative environment where every team member’s contribution is valued.

Future-Proof Your Career

Advance your career within UPMC Senior Communities through a variety of pathways, from direct care positions to administrative roles. Enjoy robust benefits, professional development programs, and a supportive work environment that encourages long-term career growth.

Explore

Discover how UPMC Senior Communities leads the way in senior healthcare innovation: - Implementing cutting-edge health technology to enhance resident care - Developing community-based programs that support holistic wellness

The UPMC Senior Communities Employment Promise

With a commitment to employee satisfaction and career development, UPMC Senior Communities ensures that all team members have the resources and support to succeed. Clients and their families rely on UPMC Senior Communities for compassionate and skilled care, making it a prime choice for those seeking meaningful employment in the healthcare sector.

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* Ladders Estimates

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