Claims Analyst, Loss Adjusting

Claims Analyst

Location : Hybrid - Rockville Centre, NY

Summary : This position is responsible for the overall handling of claims files within the Loss Adjusting Department. This includes, but is not limited to, the production of the technical claims work product, the maintenance of the claim file and the overall satisfaction of our clients with our superior claims service. The function of the position is to gather the necessary information to properly evaluate and settle claims. In addition, this position negotiates actual settlements within appropriate authority ranges with limited supervision.

Essential Functions :

• Make contact with insured, claimant and witnesses to gather pertinent information.
• Perform database searches.
• Gather information from the police, medical facilities, and any other reports related to the insurance claim.
• Prepare and coordinate field assignments to obtain relevant evidence and information.
• Review and research evidence / documents to analyze the overall fact pattern of claim and synthesize data into a professional report with recommendations.
• Prepare detailed reports that are timely, concise and in keeping with company established templates.
• Through, timely and professional file documentation.
• Maintain accurate record of billable time and timely submission of billing records for invoice preparation.
• Negotiate actual settlements within appropriate authority ranges with limited supervision.
• Consistently deliver superior customer service to both internal and external business partners.
• Empowered to make decisions within job description and authority. Seeks guidance where appropriate.
• Seeks continuous development by identifying areas for growth improvement and works with continuous improvement team to implement process and technical improvements.
• Empowers self and teammates to continuously improve RiverStoness business processes / systems and develops and escalates ideas and solutions.
• Understands Key Performance Indicators and manages towards those priorities.
• Maintains confidentiality.
• Establishes and maintains professional relationships.
• Travels if required.
• Obtains and maintains New York General Adjusters License.

Related Functions :

Required Skills :

Organizational :

Experience :

Required Education :

Four-year college degree or equivalent work experience.

Preferred Education or Certification :

Valid New York General Adjusters License or successful completion of licensing exam within six-months of start date.

Supervisory Role : None

Travel :

Limited travel required, based upon business needs.

Work Environment / Physical Demands :

This position operates in a professional cubicle based 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. While this is a largely sedentary role, the employee is regularly required to talk or hear; stand; walk; bend; use hands to handle or feel; and reach with hands and arms. On occasion the individual must be able to lift and transport boxes weighing up to 30 pounds. Other Duties (Disclaimer Statement) RiverStone retains the right to change or assign other duties to this position as needed.

Core Competencies :

Ethics and Values : Adheres to an appropriate (for the setting) and effective set of core values and beliefs during both good and bad times; acts in line with those values; rewards the right values and disapproves of others; practices what he / she preaches.

Learning on the Fly : Learns quickly when facing new problems; a relentless and versatile learner; open to change; analyzes both successes and failures for clues to improvement; experiments and will try anything to find solutions; enjoys the challenge of unfamiliar tasks; quickly grasps the essence and the underlying structure of anything.

Negotiating : Can negotiate skillfully in tough situations with both internal and external groups; can settle differences with minimum noise; can win concessions without damaging relationships; can be both direct and forceful as well as diplomatic; gains trust quickly of other parties to the negotiations; has a good sense of timing.

Problem Solving : Uses rigorous logic and methods to solve difficult problems with effective solutions; probes all fruitful sources for answers; can see hidden problems; is excellent at honest analysis; looks beyond the obvious and doesn't stop at the first answers.

Time Management : Uses his / her time effectively and efficiently; values time; concentrates his / her efforts on the more important priorities; gets more done in less time than others; can attend to a broader range of activities.

Written Communications : Is able to write clearly and succinctly in a variety of communication settings and styles; can get messages across that have the desired effect.

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.

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