Claim Sys Ops Analyst

Under general supervision, provides a variety of critical operational support services to the Claim Department, its business partners and its clients.


* Education equivalent to graduation from college or the equivalent in related work experience.


* Two or more years of experience in BSI Claim Systems/Operations or the equivalent, demonstrating a good knowledge of claim systems and field operations.


* Demonstrates effective customer relations skills.


* Demonstrates sound analytical skills.


* Demonstrates a comprehensive knowledge of claim system functions and the relationship of client information to accurate claim processing and reporting.


* Demonstrate ability to work accurately with attention to detail and customer expectations.


* Demonstrate effective and diplomatic oral and written communications skills.

#LI-RA1


* Manages and/or participates in various projects that are assigned to Claim Operations for handling to completion i.e., Take Overs, Reverse Take Overs, Novations/Buybacks.


* Manages and/or participates in various projects that are assigned to Claim Operations for handling to completion i.e., Take Overs, Reverse Take Overs, Novations/Buybacks.


* Initiates the Break Payment Process within Focus at the request of the Finance Department.

Sends notification to the field claim offices of the effective date of the break payment as well as when the break payment has been lifted.

Monitors the break payment report as well as maintains a list of clients that are on break payment and the reasons they are on break payment.

Distributes the report monthly.


* Handles all Prefund requests as received from the Finance Department.

Updating the contract number table with Clients Large Check Limits, notifying the claim offices of prefund requests and approval/release of pending payments.

Monitor daily, all payments still pending and follow up with Finance as to the status of outstanding items.

Attends weekly prefund meetings with Manager, Claim Exec and Finance.


* Manages the Priorities List and weekly priority meeting.


* Formats, tags, uploads and maintains required State forms in various claim systems.


* Creates and maintains form letters in various claim systems.


* Creates, tags, formats and maintains templates in various claim systems.


* Maintain all indexes and reports related to forms, letters, templates and state attachments in various claim systems and on public drives.


* Creates, update and maintain manuals and provides assistance/input for Claim Department Manuals.


* Provide backup coverage to others in Claim Operations as needed and/or requested.


* Assists and participates in the analysis of internal operational procedural changes/workflows and requirements.

Determines business impact and recommends and/or initiates appropriate action.


* Assists and participates in the research, writing, publishing and maintenance of operating procedures and...