Claims Quality Assurance Analyst
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Job Location:
Marlborough, NH - USA
Monthly Salary:
Not Disclosed
Posted on:
12 hours ago
Vacancies:
1 Vacancy
Job Summary
Company Details
#StopLoss #SelfFunded #accidentandhealth
Berkley Accident and Health 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 Berkleys success is our nimble approach to risk our ability to quickly understand think through and devise a plan that addresses each clients challenges coupled with the strong backing of a Fortune 500 company. Our parent company W. R. Berkley Corporation is one of the largest and best managed property/casualty insurers in the United States.
This position can either be fully remote (if not within commutable distance to the office) or based in one of our offices:
- Hamilton Square NJ
- Marlborough MA
Our offices offer a hybrid work schedule with 4 days in the office; and 1 day remote where it makes sense to do so.
The Company is an equal employment opportunity employer.
#LI-AV1 #LI-Remote
Responsibilities
As a Quality Assurance Analyst youll conduct claims related operational functions that focuses on Employer Stop Loss quality reviews. As you learn more about the organization your role may encompass SOX audits subrogation referrals overpayment/check void and refund processing external auditor requests and reserve adjustment requests. Youll be part of a small high-performing team and be a key partner helping shape best practices within the Claims function.
What you can expect:
- Culture of innovation teamwork supportive colleagues and leaders willing to invest in talent
- Internal mobility opportunities
- Visibility to senior leaders and partnership with cross functional teams
- Opportunity to impact change
- Benefits competitive compensation paid time off comprehensive wellness benefits and programs employer funded health savings account profit sharing 401k paid parental leave employee stock purchase plan tuition assistance and professional continuing education
Well count you to:
- Be responsible for department quality audit process related to: service standards adherence to procedural regulatory and financial requirements.
- Perform SOX related audits.
- Review the referral of submit monitor and track all subrogation referrals receive by the Claim department and forwarded to external vendors.
- Handle overpayment check void and refunds including maintenance of the overpayment log.
- Handle all external auditor requests for supporting documentation i.e. KPMG Captive audits.
- Handle reserve adjustment requests.
- Other duties as assigned
Qualifications
What you need to have:
- High School Diploma required
5 years of experience in first payer claims and reinsurance industry with a good understanding of our product mix.
Excellent organizational verbal and written communication as well as interpersonal and relationship building skills with the ability to influence and add value to the organization.
Detail orientated with a high degree of accuracy and ability to multitask.
Must be highly motivated and able to handle multiple priorities in a consistently changing environment.
Strong problem solving decision-making reporting and analytical skills. Must possess good judgment and work effectively with internal business areas peers and co-workers.
Demonstrated proficiency with Microsoft Office software including Word and Excel.
Ability to work independently prioritize and organize own work to meet deadlines.
- Must exhibit a professional behavior at all times while representing or being identified as an employee of Berkley Accident and Health.
What makes you stand out:
- Experience with David Young Claims System (Connexure)
- Previous audit experience a plus but must have knowledge of audit concepts and skills.
Additional Company Details
The company offers a competitive compensation plan and robust benefits package for full time regular employees which for this role include:
Base Salary Range: $80000 to $90000
Benefits: Health Dental Vision Life Disability Wellness Paid Time Off 401(k) and Profit-Sharing plans.
The actual salary for this position will be determined by a number of factors including the scope complexity and location of the role; the skills education training credentials and experience of the candidate; and other conditions of employment.
Sponsorship Details
Required Experience:
IC
Key Skills
- Test Cases
- SQL
- Quality Assurance
- Agile
- TFS
- Jira
- Software Testing
- Test Automation
- Cucumber
- QA/QC
- SDLC
- Selenium
About Company
Berkley is a leader in commercial lines insurance, with over 60+ specialized businesses - each with deep expertise in an industry, product, or regional niche.
