Claims Analyst

Claims AnalystMidwest Employers Casualty (MEC) is a member of W. R. Berkley Corporation, a Fortune 500 company rated A+ (Superior) by A.M. Best. Based in Chesterfield, Missouri, MEC improves the quality of life for employees who are severely injured on the job and helps companies understand and mitigate workers' compensation injury risk. MEC offers a friendly, results-focused work environment and seeks employees who take initiative, adapt quickly, are dependable, and work well as part of a team.ResponsibilitiesThe Claims Analyst is responsible for managing high exposure Workers Compensation claims. The primary job objectives are to proactively mitigate loss costs and settle claims by developing relationships and influencing MEC's customers and claim administrators. The role also leverages Advanced Analytics and Assisted Intelligence (A.I.) tools to enhance claim evaluation, reserve accuracy, and settlement strategies, supporting data-driven decision-making and continuous improvement.Key responsibilities include but are not limited to:Accurately evaluate WC claims for potential exposure and establish appropriate reservesUtilize predictive analytics and A.I. driven tools to provide insight into complex medical issues, evaluate trends and explore potential exposuresLead evaluation, mitigation and resolution of WC claims by collaboration with MEC Medical Management Consultants, Client Consult Managers and Claims AttorneysAchieve settlement and vendor goals and objectivesAdhere to departmental Best Practices by:Establishing, reviewing and adjusting case reserves in a timely manner within proper authority levels supported by data driven insights and A.I. assisted tools.Identifying and influencing appropriate MEC vendorsIdentifying and achieving claim settlement agreements and obtaining necessary authority to finalize resolutionMaintaining well documented claim files supported by an effective and current diary system on all assigned claimsInfluence TPA adjusters to adopt MEC recommended claim handling strategiesPlan and conduct on-sight Third Party Administrators (TPAs) visits to promote loss mitigation, vendor utilization and timely settlement across assigned portfolio of claimsCollaborate with Regional Team colleagues to support business growth and client retention through consultative engagementReview and authorize reimbursementsQualificationsBachelor's degree preferred.Frequent usage and general knowledge of WC industry accepted claim handling practices and standards with a minimum of 5 years of primary claim handling experienceHigh level of influence management skillsAbility to prioritize, organize and meet deadlinesAbility to analyze issues and barriers, find solutions and effectively implement solutionsAbility to work effectively in a team environment under general supervisionAbility to communicate frequently and effectively to internal and external contacts using both verbal and written communication skillsAbility to learn and maintain skill levels in an electronic environment.Working toward CPCU or AIC credentials preferredAdditional Company DetailsWe do not accept unsolicited resumes from third party recruiting agencies or firms. 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.Additional RequirementsOffice and remote work environment Travel required up to 25% to 35% based on customer, broker, and business needs.Sponsorship DetailsSponsorship not Offered for this Role