Insurance Claims Analyst

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Insurance & Claims Analyst - Lexington Medical Center

Insurance ServicesFull TimeMonday through Friday (8:00am - 5:00pm)

Consistently named best hospital, Lexington Medical Center dedicates itself to providing quality health services that meet the needs of its communities. Ranked #2 in the state and #1 in the Columbia metro area by U.S. News & World Report, Lexington Medical Center is the only hospital named one of the Best Places to Work in South Carolina.

The 607-bed hospital anchors a health care network that includes five community medical centers and employs nearly 8,000 health care professionals. The network includes a cardiovascular program recognized by the American College of Cardiology as South Carolina's first HeartCARE CenterTM and an accredited Cancer Center of Excellence affiliated with MUSC Hollings Cancer Center for research and education. The network also features an occupational health center, the largest skilled nursing facility in the Carolinas, an Alzheimer's care center and nearly 80 physician practices.

Job Summary

The Insurance and Claims Analyst will be responsible for assisting with all facets of claims management and insurance activities. This role will be an integral part of the Insurance Services Department with the goal of reducing risk exposures and effectively managing liability. A core function is the evaluation of events and determining efficient claim resolution. The role will also enter highly complex data, track information, and oversee claim file management.

Minimum Qualifications

Minimum Education: Bachelor's Degree Minimum Years of Experience: 2 Years of of Experience in Professional or General Liability Insurance Claims Management or Related Field Substitutable Education & Experience: None Required Certifications/Licensure: None Required Training : Basic knowledge of Microsoft Office, including Microsoft Excel and Microsoft Word

Essential Functions

• Communicating with claimants, attorneys, and other parties in regards to actual and/or potential claims facing the organization.
• Knowledge of insurance claim management, including, but not limited to, claim evaluation, investigation, and reserve setting.
• Consult and communicate with professionals and experts (i.e. Physicians, engineers, and outside legal counsel).
• Negotiate settlements under specific direction of Department leader.
• Knowledge in analyzing and interpreting insurance policies.
• Manage case summary reports from outside counsel and maintain these at requested intervals.
• Conducting assessments and evaluations to determine the associated risks involved in a situation.
• Meticulously maintaining and updating documentation and databases, including electronic claim management system and hard copy files.
• Assists in controlling the cost of processing claims.
• Gathering necessary information for insurance applications and ensuring accurate completion.
• Responsible for monitoring the receipt of insurance binders, policies, and endorsements.

Duties & Responsibilities

• Providing data analysis and preparing and processing reports.
• Undertaking research on current market/organizational risk initiatives.
• Responsible for intradepartmental communications and gathering documents and information for outside legal counsel, insurance representatives, and experts.
• Coordinate scheduling and oversee file management.
• Provide administrative support for the departments such as answering telephones, maintaining calendars, assisting visitors, and resolving a range of administrative inquiries.
• Develops spreadsheets, reports, worksheets, and/or forms to improve workflow and communication, as needed.
• Support various staff meetings, including scheduling, processing room set-up requisitions, attending, recording and distributing minutes and agendas.
• Sorts, screens, reviews, and distributes incoming/outgoing mail and initiates action as assigned by authorized personnel.
• Processes check requests, orders supplies, and places work orders, as needed.
• Other duties as assigned at the direction of Department leaders in Insurance Services and Risk Management.

We are committed to offering quality, cost-effective benefits choices for our employees and their families:

• Day ONE medical, dental and life insurance benefits
• Health care and dependent care flexible spending accounts (FSAs)
• Employees are eligible for enrollment into the 403(b) match plan day one. LHI matches dollar for dollar up to 6%.
• Employer paid life insurance - equal to 1x salary
• Employee may elect supplemental life insurance with low cost premiums up to 3x salary
• Adoption assistance
• LHI provides its full-time employees employer paid short-term disability and long-term disability coverage after 90 days of eligible employment
• Tuition reimbursement
• Student loan forgiveness

Equal Opportunity Employer It is the policy of LMC to provide equal opportunity of employment for all individuals, and to remain compliant with applicable state and federal laws and regulations. LMC strives to provide a discrimination-free environment, and to recruit, select, on-board, and employ all employees without regard to race, color, religion, sex, age, disability, national origin, veteran status, or pregnancy, childbirth, or related medical conditions, including but not limited to, lactation. LMC endeavors to upgrade and promote employees from within the hospital where possible and consistent with the employee's desires and abilities and the hospital's needs.

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee discount
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Referral program
• Vision insurance

Physical setting:

• Office

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Education:

• Bachelor's (Required)

Experience:

• Prof. or Gen. Liability Insurance Claims Management: 2 years (Required)

Work Location: In person