Claims Analyst

Position: Claims Analyst (2)

Reports to: Director of Claims

Location: Hamilton, NJ or Marlborough, MA

Berkley Accident and Health (Berkley) is a risk management company that designs innovative solutions to address the unique challenges of each client. With our entrepreneurial culture and a strong emphasis on analytics, we can help employers better manage their risk. We offer a broad range of products, including employer stop loss, benefit captives, provider stop loss, HMO reinsurance, and specialty accident. The key to Berkley’s success is our nimble approach to risk — our ability to quickly understand, think through, and devise a plan that addresses each client’s challenges, coupled with the strong backing of a Fortune 500 company. We are a member company of W. R. Berkley Corporation, one of the largest and best managed property/casualty insurers in the United States.

Berkley Accident and Health is seeking a full-time Claims Analyst. This position, reporting to our Director of Claims, will focus on claims adjudication of Employer Stop Loss and Captive claims, with an emphasis on carrier (Blues, UHC, CIGNA, Aetna) business.

The individual in this position will work closely with the claims and medical management departments. The impact of this position is accurate and timely claims adjudication and superior customer service.

Claims Analyst Essential duties include:

• Process employer stop loss and captive claims within defined authority limits
• Handle customer service calls and correspondence from Brokers and TPAs
• Participate in Installation calls and meetings for all product lines
• Other duties as assigned

Claims Analyst Qualifications include:

• 5+ years claims experience in the reinsurance industry
• Knowledge of medical terminology, ICD9; ICD10 and CPT codes
• Excellent analytical, problem solving, time management, and organizational skills, with an attention to detail
• Ability to work productively while maintaining excellent quality
• Proficient in Microsoft Office software • Knowledge of David Young system preferred
• Excellent verbal, written, and interpersonal skills • Ability to work independently and as team member
• Ability to demonstrate initiative and take ownership of tasks to completion
• Ability to communicate with both internal and external customers and provide superior customer service in an effective and timely manner • Solid work ethic and positive attitude
• Excellent attendance record