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UPMC complies with all governmental requirements related to local, state, and federal COVID-19 vaccination for employment. The Jan. 13 Supreme Court of the United States decision that the Centers for Medicare & Medicaid Services federal COVID-19 vaccine mandate will move forward requires UPMC to ensure employees either get vaccinated or receive a requested medical or religious exemption.

If you are not yet vaccinated, we urge you to get a vaccine now. You can schedule your COVID-19 vaccination through UPMC or visit a non-UPMC provider or UPMC Urgent Care location.

Proof of vaccination is not required upon hire; however, employees will be responsible for ensuring post-hire compliance by getting vaccinated or requesting a medical or religious exemption.

For more information about UPMC’s response to COVID-19, please visit UPMC.com/coronavirus.

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   Current UPMC employees must apply in HR Direct

Senior Claims & Insurance Analyst

  • Job ID: 225815468
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: Corporate Legal
  • Department: Corporate Captive Ins
  • Location: 600 Grant St, Pittsburgh PA 15219
  • Union Position: No
  • Salary Range: $31.08 to $52.46 / hour

Description

At UPMC, we’re all here for the same reason — to make Life Changing Medicine happen. Join our team and you will play a unique and important role in our mission to change healthcare for the better. 

Why Join UPMC? 

We don’t just take care of patients — we take care of our team, too. And we have the data to prove it. In addition to the benefits you’d expect from an industry leader you can expect: 

  • AWARD-WINNING WORKPLACE: Ranked #1 for Best Places to Work for Women & Diverse Managers by Diversity MBA. 
  • Competitive pay 
  • Tuition reimbursement 
  • Opportunities to grow in your career at UPMC 

We are hiring immediately for a Senior Claims & Insurance Analyst.  This role manages complex claims involving primary and excess insurance coverages, significant litigation, and extensive liability.  The analyst monitors claims work on complicated claims and assume responsibility for reviewing claims for settlement potential.  Additionally, the analyst manages the litigation services provided by all subcontracted defense attorneys and conducts comprehensive audits of litigated files.

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.

 

Qualifications

  • Associate's degree in Business, Communications, or a related field and five years of claims management experience dealing with indemnity claims OR Bachelor's degree in Business, Communications, or a related field and three 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, and good personal computer skills.


Licensure, Certifications, and Clearances:

  • Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran

Total Rewards

More than just competitive pay and benefits, UPMC’s Total Rewards package cares for you in all areas of life — because we believe that you’re at your best when receiving the support you need: professional, personal, financial, and more.

Our Values

At UPMC, we’re driven by shared values that guide our work and keep us accountable to one another. Our Values of Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, Excellence & Innovation play a vital role in creating a cohesive, positive experience for our employees, patients, health plan members, and community. Ready to join us? Apply today.

   Current UPMC employees must apply in HR Direct