Complex Claims Analyst
Riverstone Resources
Job Description
Job Description
Summary
Reporting to the Unit Manager, this role will be responsible for direct handling of multi-line commercial claims including Auto, General Liability and Construction Defect claims. Duties include investigation and evaluation of coverage, liability and damages issues. The role will be responsible for claim evaluation, establishment/recommendation of adequate reserves, litigation management, case resolution and transaction processing in alignment with the Company’s and Client’s Strategic Vision.
Essential Functions
- Directly handles and/orassistsin monitoring, reviewing, and coordinating the activities involving multi-line commercial insurance claims, including analysis of coverage issues, establishment of adequate reserves, and the resolution and closure of claims.
- Reviews loss notices; confirms and interprets policy coverages; establishesadequate reserves; and investigates and handles claims involving primary,umbrellaand excess policies.
- Ensures proper file setup, reserving, generalhandlingand application of companyprocedure.
- Manages litigation with Preferred Counsel under Alternative Fee Arrangements or other defense fee structures.
- Pursues and maximizes all risk transfer opportunities by contract or by insurance policy language.
- Assigns and manages work of defense counsel, assignment of expert witnesses and interfacing with peer carriers including design and execution of defense and indemnity contracts, evaluation of liability and damages and participation in settlement negations.
- Participates in developing claims handlingstrategy, including defense coordination, litigation strategy and budgets, and expense control.
- Records specificclaimsinformation and reports asappropriate toa managerrelativeto pertinent financial and general statistical records.
- Maintains diary control, investigates, analyzes, and reports to ensure maintenance of proper reserves to reflect the company’s exposure and reports to our Reinsurance Department toassistin providing notice to reinsurers and the Reinsurance Department’s recovery of specific amounts when payment exceeds the company’s retention.
- Handles largevolumeof diverse and dynamic claims effectively.
- Empowered to make decisions within job description and authority. Seeks guidance whereappropriate.
- Develops creative ideas and solutions to real time business problems and /or business opportunities; Takes reasonable, calculated risks even if failure is possible.
- Seeks continuous development byidentifyingareas for growth improvement and works with team to implement process and technical improvements
Experience
Minimum of 2+ years’ experience in claims or related field.
Required Education
Four-year college degree or equivalent work experience.
Preferred Education or Certification
Click here to enter text.
Supervisory Role
None
Travel
As required, based upon business needs.
Work Environment / Physical Demands
This position operates in a professional, collaborative environment and must have the ability to timely produce thorough, accurate work with many competing demands, deadlines, and distractions. The position uses standard equipment such as phones, computers, copiers/printers and filing cabinets. Noise level is moderate. Other Duties (Disclaimer Statement): RiverStone retains the right to change or assign other duties to this position as needed, or other duties or responsibilities may change or be assigned as needed.
Diversity, Equity, Inclusion & Belonging
RiverStone Resources, LLC is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, LGBTQ+, national origin, gender identity, disability, protected veteran status, or any other characteristic protected by law.
Privacy Notice for California Residents
-consumer-privacy-notice/
$72k - $141k
...This individual contributor position works under general direction, and within broad authority limits, to manage commercial claims with high complexity and exposure for a specialized line of business. Responsibilities include the coordination of all claim resolution...SuggestedFull timeWork experience placementWork at officeLocal areaShift work$116k - $165k
...service providers. This role will support the business and interact with these key customers. In this Medical Malpractice focused Complex Claims Consultant position, you will be responsible for the overall investigation, management and resolution of Allied Healthcare...SuggestedFull timeWork experience placementWork at officeLocal areaFlexible hoursShift work$147k - $241.5k
...ensuring the abilities of all employees are used to their fullest potential. Leads a team of Claims Consultants and Consulting Directors that are responsible for the handling of complex, high exposure mass tort and environmental claims, including social media addiction,...SuggestedFull timeWork experience placementWork at officeLocal area- ...Rochester, NY, or Hamilton, NJ office, with the option for a hybrid schedule after the training period. ** General Summary: A Complex Claims Specialist will possess experience in handling complex medical liability claims, while demonstrating a strong client service...SuggestedWork at officeNight shift
$97k - $189k
...contributor position works closely with senior level leaders and within the broadest authority limits, to manage the most complex, highest exposure commercial claims for a specialized line of business. Responsibilities include the management of all claim resolution activities in...SuggestedFull timeWork experience placementWork at officeLocal areaShift work- ...environment in Norwich, NY. This position involves adjudicating new, renewal, and modification loan applications, particularly for larger, complex relationships. Candidates should have a BS in Business Administration or related fields, alongside experience in commercial lending...
- ...Job Description Job Description **This is an on-site position located in Roslyn, NY** General Summary: A Claims Analyst Trainee will join an entry‑level program that provides structured training and hands‑on experience to prepare participants to review, investigate...Full timeTemporary workTraineeshipWork experience placementWork at officeTrial periodMonday to FridayShift work
$88k - $112k
...The Casualty Claim Representative will be responsible for the handling of First- and Third-Party Bodily Injury claims in a Personal Lines... ...claims. Refer to SIU for investigation timely. Handle complex claims to include coverage issues, UM/UIM, TNC, Commercial, Umbrella...$72k - $141k
...talents to their fullest potential. This individual contributor role operates under broad authority to manage commercial claims of high complexity and exposure within the Commercial Auto/General Liability/ Construction Auto and General Liability line(s) of business. The...Full timeWork experience placementWork at officeFlexible hours- ...Claims Business Analyst Duration-6 – 12 months ++ Hybrid 3 Days a week: Charlotte, NC; Chicago, IL; Colorado Springs, CO; Conshohocken, PA; Dallas, TX; Fargo, ND; Garden City, NY; Houston, TX; Jacksonville, IL; Lenexa, KS; Los Angeles, CA; Lubbock, TX; Morristown...3 days per week
$90k
...identified Ideal Candidate Profile This role is well suited for someone who thrives in a deadline-driven environment, enjoys managing complex documentation, and has experience navigating school district procurement processes. The successful candidate will ensure the...Full timeContract workTemporary workPart timeWork at officeLocal areaFlexible hours- ..., terms, and conditions through the analysis and evaluation of complex information. Operate with a high level of authority and independent... ...loss ratio objectives with assigned agents and brokers. Review claims activity and loss history, taking appropriate actions to manage...Full timeWork experience placementWork at officeFlexible hours
$99k - $232k
...Description & SummaryThe OpportunityAs a Property & Casualty Insurance Claims Operations Consultant, Manager, you will play a pivotal role in... ...technology solutions in insurance operations- Managing complex projects with a focus on client satisfaction- Leading teams in...Full timeH1b- ...Job Description Job Description The Claims Specialist is responsible for effectively managing and resolving complex medical claims disputes. This role requires a strong understanding of healthcare regulations, excellent communication and interpersonal skills, and...Work at office
$21 - $22.5 per hour
...members by facilitating the delivery of quality care. Interested in joining our successful Garden City Team? We are currently seeking a Claims Assistant! Position Summary: The Claims Assistant supports the Claims and Complaints & Grievances departments by performing...Hourly payFull timeWork at officeLocal areaWeekend workAfternoon shift- ...of Group Health and Workers' Compensation Hospital and Medical claims. Resolve claim holds, review history records, and determine... ...skills, with the ability to identify discrepancies and resolve complex claim issues. ~ Proficiency with claims processing systems, data...Full timeWork at officeRemote work
- Insurance Underwriter Our client is a national commercial and personal line insurance wholesaler, serving as a trusted partner for retail insurance brokers. As a "high tech high touch" organization, we focus on providing brokers with new products, markets, and online...
$20 - $25 per hour
...Claims Referral Specialist II (Remote - East Coast) Bring Your Dental Claims Expertise to a Mission-Driven Organization Eastern Time Zone - Uniondale, NY About Liberty Dental Plan At Liberty Dental Plan, we are committed to improving the oral health of the communities...Work at officeImmediate startRemote workRelocationVisa sponsorshipFlexible hours- ...CNA Insurance in the United States is seeking an experienced claims professional to manage a portfolio of commercial claims with moderate to high complexity. You will verify policy coverage, conduct investigations, and develop resolution strategies within authority limits...Flexible hours
$130k - $160k
...their acquisitions team. This role focuses on analyzing commercial real estate investments, building financial models, and evaluating complex deals across multiple asset classes. Responsibilities • Underwrite commercial real estate acquisitions and financing...$30.59 - $40.76 per hour
...$40.76 Within a loan production environment adjudicate new, renewal and modification loan applications typically for larger, more complex relationships and loan structures, and industry specific lending. Accurately and thoroughly communicate loan decisions to internal...Full timeTemporary workPart timeLocal areaWork visaFlexible hours- ...looking for an individual who is efficient and comfortable being a member of a team. The ability to multi-task, while maintaining complex schedules and managing administrative support, is essential in this position. The ideal candidate for this job is hard-working, reliable...
$27.47 - $29.4 per hour
Insurance Assistant Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. Brown & Brown is seeking an Insurance Assistant for our team in Garden City, NY! The Insurance Assistant...Hourly payWork experience placementWork at office$100k
...PrestigePEO helps businesses build stronger teams, remain compliant in complex regulatory environments, and focus on sustainable growth.... ...exposure, including industry classification, loss history, claims trends, and safety programs Pricing & Quoting: Develop and recommend...Work at officeWork from home- ...service. Service can include responding to inquiries regarding insurance availability, eligibility, coverages, policy changes, transfers, claim submissions, and billing clarification. What We Provide Base Salary plus commission/bonus Valuable experience...Base plus commissionFull timeWork at officeImmediate start
- CareConnect is seeking an Underwriter in Greenvale, NY, to monitor and analyze underwriting performance based on claims experience, develop financial projections, and assess financial risks for new and renewal business. This role requires a Bachelor’s Degree in Finance...
- Crum & Forster is seeking an experienced Executive Underwriter in Uniondale, NY, responsible for overseeing the Contract Surety product underwriting. This role entails developing relationships with brokers and growing a profitable book of business while ensuring compliance...Contract workFlexible hours
- ...and physician practices throughout downstate New York. Job Description Monitors and analyzes underwriting performance based upon claims experience. Utilizes underwriting and financial principles to develop rates, projections and recommendations for benefit changes....
$55k - $70k
...service. Service can include responding to inquiries regarding insurance availability, eligibility, coverages, policy changes, transfers, claim submissions, and billing clarification. Develop leads, schedule appointments, identify customer needs, and market appropriate...Hourly payFor contractorsWork at office$50k - $80k
Job Description The Auto Property Damage Claims Representative is responsible for managing Auto Property Damage claims within our Auto PD Claim Unit. This role demands a high level of customer service, patience, and professionalism while working in a fast-paced environment...Work at office
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Complex Claims Analyst. Be the first to apply!
- remote medical claims processor Garden City, NY
- medical insurance claims specialist Garden City, NY
- claims processing Garden City, NY
- property claims Garden City, NY
- medical claims auditor Garden City, NY
- claim handler
- remote medical claims processor
- senior claims handler
- claims resolution analyst
- claims assistant


