Claims & Insurance Analyst Sr.

Manages complex claims involving primary and excess insurance coverages, significant litigation, and extensive liability; monitors claims work on complicated claims; assumes responsibility for reviewing claims for settlement potential; managing the litigation services provided by all subcontracted defense attorneys; and conducts comprehensive audits of litigated files.

This position will work on site for the first 3 months for training and hybrid (2-3 days in office, once trained.

Responsibilities:

• Identify and negotiate cost effective claim resolutions/settlements up to designated financial authority or prepare for review/approval by President.
• Complete special projects and contribute to daily Risk Management Initiatives as directed by the President or Director.
• Serve as the representative of UPMC Corporate & Captive in regard to communicating all legal aspects of claims activity between UPMC and the various commercial insurers and their respective defense firms.
• Assist the Director of Corporate & Captive Insurance (Director with administrating all commercial lines of coverage, including all claims activities associated with the various UPMC commercial policies.
• Assist the President and Director of annual policy review of each individual insurance policy written through UPMC Captive Insurance Program.
• Prepare and issue all reservation of rights letters on behalf of UPMC Captive Insurance Program, including submitting and coordinating all necessary documentation to commercial carriers of potential and filed lawsuits.
• Review daily correspondence to maintain comprehensive claims database with settlements, dismissals, demands, financial reserves and trial dates.
• Work with the President, Captive Insurance Program & Counsel (President to evaluate and coordinate in-house and external counsel assignments for each case.
• Analyze complex, technically challenging, and/or sensitive employee related and third party claims that are submitted for coverage under one of, but not limited to, UPMC Captive policies; Directors & Officers Liability, including Employment Practice Liability, Managed Care Errors & Omissions, General Liability and Professional (malpractice liability.
• Prepare all legal correspondence to all program insured(s and attorneys.
• Field a wide variety of phone calls/emails from insureds regarding insurance coverage and claims questions and what to expect during the legal discovery process.
• Coordinate and prepare all necessary information for review by President.
• Maintain excellent professional relationships with clients, internal as well as external.
• Manage the litigation services provided by all subcontracted defense attorneys and conduct comprehensive audits of litigated claim files.
• Monitor excess insurance coverages and reserves on a continuous basis.
• Provide direction to claims staff (insurance brokers and carriers to ensure compliance with Claims Service Standards as well as continuously refining and improving claims handling procedures for UPMC's Corporate & Captive Insurance Program.
• Work with President to develop, assign, and carefully monitor reserves for each claim.
• Coordinate and conduct regular claim reviews with internal and external staff/clients/defense attorneys.
• Associate's degree in Business, Communications, or a related field and 5 years of claims management experience dealing with indemnity claims OR Bachelor's degree in Business, Communications, or a related field and 3 years of claims management experience dealing with indemnity claims.
• Extensive technical knowledge of claims management and settlements required. Excellent negotiating skills. Excellent interpersonal skills. Leadership abilities.
• Excellent written and verbal communication skills. Ability to communicate clearly via telephone. Good personal computer skills.

Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran