Claims Analyst - Schaumburg, United States - OMS NATIONAL INSURANCE CO

Description

At OMS National Insurance Co. our mission is simple. We are dedicated to serving and protecting oral and maxillofacial surgeons and dental professionals nationwide.

If you are a legal or claims professional, and wish to be part of a growing, well-respected industry leader, OMSNIC could be the right place for you.

We offer a robust array of benefits to support our employees
- generous PTO, long-term incentive plan, affordable and comprehensive benefits plans, a hybrid work schedule, tuition assistance and opportunities to advance your career. What makes us special is our collaborative culture and the impact we make as a team.

Claims Analysts have direct contact with our policyholder doctors and are regarded as trusted partners, managing an assigned caseload of claims.

This includes the investigation, evaluation, and resolution of both pre-litigation and litigated matters.


WHAT YOU WILL DO:


Claims Management
Evaluate coverage

Assign and collaborate with defense counsel

Review and analyze medical records

Investigate and evaluate issues of liability, causation, and damages, proactively moving the files toward resolution

Participate in the formulation of case strategy

Negotiate claims in a settle posture

Evaluate indemnity and expense reserves

Prepare Comprehensive Claim Reports

Present claims to management and for internal review

Keep policyholders informed of the status

Timely and accurately document claim files

Help maintain claim file data for accurate reporting

Review and approve bills


General:

Planning and participation in Risk Management and Defense Counsel Seminars

Contribute to departmental and company goals, initiatives and projects

May attend or participate in training and development programs

May participate in the training and development of new hires

Occasional travel will be required


EDUCATION AND EXPERIENCE:

Bachelor's Degree required; might consider a demonstrated equivalent professional experience

JD preferred

Minimum 3 years' experience in the legal, insurance, or medical professional liability claims management field

Working understanding of medical records

Microsoft Office Suite proficiency with emphasis on Word, Excel and PowerPoint


COMPETENCIES:

Strong organizational and time management skills, ability to meet deadlines

Effective written and oral communication skills to provide information in a clear and concise manner and to communicate with variety of stakeholders

Effective analytical and critical thinking skills to analyze facts and draw conclusions to make recommendations and resolve issues

Ability to prepare robust reporting yet provide a broad scope overview and summary, when appropriate

Superior customer service skills and ability to actively listen

Strong interpersonal skills with ability to interact with policyholders, legal professionals, management, co-workers, agents, committee and board members, and external venders

Strong mediation and negotiation skills