Claims analyst jobs in United States
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Acrisure · 17 hours ago

Claims analyst

Acrisure is a company focused on building a community where people can grow and thrive. The Claims Analyst role involves independently adjudicating multi-state workers’ compensation claims and managing various aspects of the claims process, ensuring effective communication with all parties involved.

Financial ServicesInsuranceInsurTech

Responsibilities

Receives lost time assignments. Verifies and determines applicability of coverage. Completes 24 hour contact with employer, employee and attending physician inclusive of telephonic contact, recorded statements and/or in person interviews with insured, employee, physician, and witnesses
Reviews all coverage issues and determines compensability within Midwest standards
Aggressively manages all aspects of the workers’ compensation claims management process inclusive of litigation, and providing direction to defense counsel
Responsible for customer relations management, consistently establishing and maintaining high levels of trust and confidence with clients, through constant contacts, prompt response and resolving client’s questions and claim issues
Responsible for setting of reserves to Ultimate Probable Cost (UPC).Sets reserves for anticipated exposure subject to authority limits
Addresses timely benefit delivery including production of benefit notices to the injured party as required in the applicable jurisdiction
Coordinates return to work (RTW) in accordance with the medical disability plan for the injured worker
Negotiates settlements directly with the injured worker or opposing counsel
Considers Medicare’s interests related to Conditional payments and injured workers eligibility and settlements
Recognizes and manages 3rd party liability and subrogation through recovery
Reviews medical and expense bills for causal relationship and bill charges over $1500.00
Consults with Claim Supervisor/Claims Manager/Executive claims on files where assistance and consultation are needed
Completion of Claim Status reports
Makes assignments to nurse case management when indicated, monitoring their billing and performance
Coordinate claim review meetings with both internal and external parties
Attend hearings and depositions when required
All other duties as assigned

Qualification

Workers' compensation claimsClaims management processCustomer relations managementNegotiation skillsMedical bill review

Required

Independently adjudicates multi-state workers' compensation indemnity, EL and subrogation claim files that are generally non-catastrophic in nature
Receives lost time assignments
Verifies and determines applicability of coverage
Completes 24 hour contact with employer, employee and attending physician inclusive of telephonic contact, recorded statements and/or in person interviews with insured, employee, physician, and witnesses
Reviews all coverage issues and determines compensability within Midwest standards
Aggressively manages all aspects of the workers' compensation claims management process inclusive of litigation, and providing direction to defense counsel
Responsible for customer relations management, consistently establishing and maintaining high levels of trust and confidence with clients, through constant contacts, prompt response and resolving client's questions and claim issues
Responsible for setting of reserves to Ultimate Probable Cost (UPC)
Sets reserves for anticipated exposure subject to authority limits
Addresses timely benefit delivery including production of benefit notices to the injured party as required in the applicable jurisdiction
Coordinates return to work (RTW) in accordance with the medical disability plan for the injured worker
Negotiates settlements directly with the injured worker or opposing counsel
Considers Medicare's interests related to Conditional payments and injured workers eligibility and settlements
Recognizes and manages 3rd party liability and subrogation through recovery
Reviews medical and expense bills for causal relationship and bill charges over $1500.00
Consults with Claim Supervisor/Claims Manager/Executive claims on files where assistance and consultation are needed
Completion of Claim Status reports
Makes assignments to nurse case management when indicated, monitoring their billing and performance
Coordinate claim review meetings with both internal and external parties
Attend hearings and depositions when required
All other duties as assigned

Benefits

Comprehensive medical insurance
Dental insurance
Vision insurance
Life and disability insurance
Fertility benefits
Wellness resources
Paid sick time
Generous paid time off and holidays
Employee Assistance Program (EAP)
A complimentary Calm app subscription
Immediate vesting in a 401(k) plan
Health Savings Account (HSA) and Flexible Spending Account (FSA) options
Commuter benefits
Employee discount programs
Paid maternity leave
Paid paternity leave (including for adoptive parents)
Legal plan options
Pet insurance coverage

Company

Acrisure

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Acrisure offers financial services solutions for insurance, reinsurance, real estate, cyber services, and asset and wealth management.

Funding

Current Stage
Late Stage
Total Funding
$11.37B
Key Investors
Bain Capital Special SituationsAbu Dhabi Investment AuthorityBDT & MSD Partners
2025-06-06Debt Financing· $550M
2025-05-20Private Equity· $2.1B
2024-06-05Debt Financing· $1.6B

Leadership Team

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Greg Williams
Co-Founder, Chairman & CEO
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Mark Wassersug
Chief Technology Officer
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Company data provided by crunchbase