Financial Analyst, Insurance Risk & Claims

Financial Analyst, Insurance Risk & Claims

The Financial Analyst – Insurance Risk & Claims serves as the critical financial and analytical bridge between Corporate Risk Management, Treasury, General Ledger Accounting, FP&A, and external actuarial partners. This role oversees the end-to-end administration and reporting of self-insured claims, third-party administrator (TPA) expenses, insurance reserves, and loss runs across all consolidated business entities (including DCI, Quala, and PSC).

The role is responsible for maintaining the integrity of the Risk Management Information System (Origami Risk), managing strict cash prefunding and claim payment workflows, coordinating cross-functional executive monthly reviews, and partnering with actuaries on reserve valuations.

Reports To: VP of Insurance & Claims

Employment Type: Full-Time

Location: Hybrid / On-Site at our HQ in Tampa, FL

Key Responsibilities & Essential Functions

1. Claims Financial Operations, Invoicing & Cash Flow Management

• Claims & Prefunding Invoicing: Review and validate weekly CBCS claim invoices, prefunding requests, and quarterly prepaid service fees under tight deadlines (strict 5-day and immediate same-day terms).
• Treasury & ACH Coordination: Initiate urgent, same-day manual ACH releases with Treasury for critical claim prefunding accounts.
• Bank & Subledger Reconciliations: Perform monthly BRS/Occidental bank reconciliations and Origami subledger-to-GL reconciliations against general ledger accounts (e.g., account 481103) to track timing variances, claim settlements, and cash fluxes.
• TPA Contractual Reconciliations: Conduct annual reconciliations of CBCS prepaid expenses vs. actual fees incurred under active service agreements, auditing charges on a claim-by-claim basis to identify overpayments and dispute discrepancies.
• Consolidated Loss Run Production: Extract, aggregate, and reconcile monthly loss runs across internal platforms (QC and DCI Origami) and external TPA feeds (CBCS, Sentry, ACE/ESIS).
• Executive Reporting Package: Build, maintain, and automate the monthly Insurance Reporting Package and executive claim expense trending models (YTD P&L trends, pre-close and final close updates).
• Watchlist Maintenance: Update and distribute the corporate Insurance Watchlist reflecting case developments, significant reserve changes ($5k+ threshold), and executive leadership adjustments.
• Uninsured Allocations: Generate monthly uninsured claim transaction reports by Day BD+1 to calculate pivot-table cost allocations for corporate accounting journal entries.

3. Actuarial Support & Executive Governance

• Executive Committee Facilitation: Organize, schedule, and assemble materials for the monthly Executive Insurance Review Meeting, aligning senior stakeholders across Legal, Operations, Accounting, and FP&A.
• Actuarial Deliverables: Provide finalized, audit-ready loss runs and exposure exhibits to external actuaries (Pinnacle) within tight deadlines post-meeting, incorporating approved reserve adjustments.

4. RMIS Administration & Process Improvement

• Origami System Administration: Manage user licenses, distribution groups, claimant metadata, and system security.
• Integration Oversight: Monitor weekly automated API/EDI data feeds between external TPAs (CBCS) and Origami, troubleshooting and clearing data transfer integration exceptions.
• Process Automation: Spearhead initiatives and automation tools (including AI/macro models) to streamline complex data consolidation and eliminate manual reporting errors.

Core Tasks & Operating Rhythm

• Review and approve weekly CBCS claim and prefunding invoices (Wednesdays).
• Audit weekly automated CBCS-to-Origami data feed imports on Mondays.
• Perform weekly GL expense scrubs (Account 481103) for claim reclasses and cost trends.
• Review prefunding expenses and GL timing offsets.
• Monthly (Close & Reporting)
  • BD+1: Extract QC/DCI Origami uninsured transaction reports for accounting allocation.
  • BD+1 to BD+5: Ingest TPA loss runs, complete BRS bank reconciliations, and distribute partner packages.
  • Consolidate master loss runs across all operating entities and TPAs.
  • Finalize Subledger (Origami) vs. GL (Great Plains/ERP) claim reconciliations.
  • Coordinate, prepare materials for, and facilitate the Executive Insurance Meeting.
  • Deliver final post-meeting actuarial loss runs and updated Watchlists to Pinnacle.
• Audit and track legacy self-insurance claims against designated balance-sheet reserve accounts and add-back categories (e.g., Account 594140).
• Annual
  • Audit TPA prepaid expenses vs. actual contract fee schedules (July).
  • Collate headcount, payroll, and revenue exposure exhibits for annual policy renewals (September).
• Ad Hoc
  • Origami user administration, permissions, and email routing changes.
  • Investigate claim coding reclassifications with field depots and corporate accounting.

Required Education & Experience

• Education: Bachelor’s degree in Accounting, Finance, Risk Management, or related quantitative field.
• Experience: 4–7+ years of progressive experience in corporate accounting, financial analysis, or risk management finance.
• System Experience: Hands-on working experience with Origami Risk (or equivalent enterprise RMIS platform) and ERP financial systems (e.g., Microsoft Dynamics Great Plains, NetSuite, SAP).
• Claims & TPA Knowledge: Demonstrated understanding of insurance loss runs, third-party administrators (CBCS, ESIS/ACE, Sentry), self-insured retention (SIR), and casualty claim structures.
• Advanced Financial Modeling: Advanced Microsoft Excel proficiency (complex pivot tables, Power Query, dynamic lookups, nested logic, and large dataset handling).
• Reconciliation Expertise: Proven track record reconciling subledgers to General Ledger accounts, balancing cash transactions with bank statements, and identifying balance sheet accrual gaps.
• Process Modernization: Experience using automation, macros, or AI-enabled tools to streamline manual recurring data processes.
• Executive Communication: High-caliber interpersonal and organizational skills to manage schedules and present materials to senior executive stakeholders (Legal, Accounting, FP&A, Operations).
• Medical, Dental and Vision Insurance
• 401(k) with generous employer match
• Paid time off
• 10 Paid holidays
• Optional Health savings account & Flexible spending account