Senior Claims Management Analyst

AIG - Shawnee, KS

Full-time - Senior

Shawnee, KS

Insurance Carriers and Related Activities

About the position

Join us as a Senior Claims Analyst to grow your experience in handling complex claims. Make your mark in Claims. Our Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience. Through a robust stakeholder feedback loop and supported by consistent processes and leadership, we take pride in delivering responsive, fair and professional service with empathy and efficiency. As a Senior Claims Analyst, you will oversee claim specific TPA activities involving policy coverage and management of indemnity, medical and legal aspects of the highest valued, complex claims. You will review and analyze TPA claim financials to ensure payments are appropriate and accurately coded, deductibles/retentions are properly eroded, and excess reimbursements are processed timely and accurately. Your role will involve completing an independent analysis and evaluating claim exposure on assigned files with a focus on establishing appropriate reserves within assigned authority and in recognition of AIG's exposure above the deductible. You will continually evaluate reserves during the life of the claim to ensure accuracy of financial exposure and identify and make reserve recommendations to management on claims evaluated greater than assigned authority. In this position, you will work with and provide direction to TPAs to develop resolution strategy plans (action plans), continually assess and update plans to achieve appropriate claim results and timely closure. You will provide settlement authority to TPAs and oversee negotiations to achieve claim settlements within authority limits. Additionally, you will review claims for subrogation opportunities and evaluate requests for WC lien waivers. As a technical expert, you will be responsible for the completion of Major Loss Reports (MLRs) for assigned cases detailing significant reserve activity and disposition strategies on the highest value/most complex claims. Experience managing Major Loss and CAT claims is essential, and multiple jurisdiction experience and licensing are preferred. You will communicate with internal and external customers on complex technical issues and participate in external customer claim file reviews and audits as required, investigating TPA E&O and pursuing recovery where applicable.

Responsibilities

• Oversee claim specific TPA activities involving policy coverage and management of indemnity, medical and legal aspects of highest valued, complex claims.
• Review and analyze TPA claim financials to ensure payments are appropriate and accurately coded, deductibles/retentions are properly eroded, and excess reimbursements are processed timely and accurately.
• Complete an independent analysis and evaluate claim exposure on assigned files with a focus on establishing appropriate reserves within assigned authority.
• Continually evaluate reserves during the life of the claim to ensure accuracy of financial exposure.
• Identify and make reserve recommendations to management on claims evaluated greater than assigned authority.
• Work with and provide direction to TPAs to develop resolution strategy plans (action plans).
• Continually assess and update plans to achieve appropriate claim results and timely closure.
• Provide settlement authority to TPAs and oversee negotiations to achieve claim settlements within authority limits.
• Review claims for subrogation opportunities and evaluate requests for WC lien waivers.
• Act as technical expert responsible for completion of Major Loss Reports (MLRs) for assigned cases detailing significant reserve activity and disposition strategies on the highest value/most complex claims.
• Communicate with internal and external customers on complex technical issues and participate in external customer claim file reviews and audits as required.
• Investigate TPA E&O and pursue recovery, where applicable.

Requirements

• Minimum of 10+ years of workers compensation claim handling experience.
• Bachelor's degree from a 4-year college or university (preferred).
• Ability to make independent decisions within prescribed authority limit.
• Strong (oral/written) communication and interpersonal skills.

Benefits

• Comprehensive benefits package focused on health, wellbeing, and financial security.
• Professional development opportunities.
• Flexible work arrangements.
• Diversity and inclusion learning programs.
• Cultural awareness activities and Employee Resource Groups (ERGs).