United States onlyYour Impact:
Analyze complex, high‑volume claims data using investigative and analytical techniques to uncover discrepancies, emerging trends, root‑cause issues, and potential risk exposures, translating insights into actionable recommendations that enhance accuracy, efficiency, and claim outcomes.
Conduct thorough reviews of claim files to ensure full compliance with company policies, regulatory requirements, and industry standards, proactively identifying gaps, inconsistencies, or opportunities to strengthen adherence and reduce financial or legal risk.
Develop comprehensive, data‑driven reports that clearly articulate findings, performance metrics, and improvement opportunities, and confidently present insights to management to support strategic decision‑making and process optimization.
Collaborate closely with claims teams, legal partners, and key stakeholders to resolve complex issues, streamline workflows, and implement best practices that improve claim quality, turnaround times, and customer experience.
Mentor and support junior analysts by providing hands‑on coaching, constructive feedback, and technical guidance, helping to build their expertise, manage workloads effectively, and foster professional growth within the claims organization.
Successful Candidates Will Have:
- Bachelor's degree in Business, Insurance, or related field.
- 5+ years of relevant claims experience.
- Strong analytical and negotiation skills.
- Proficiency in claims systems and insurance regulations.
Physical Demands and Work Environment:
The employee must be able to effectively manage the demands of a fast-paced work environment. This includes the ability to adapt to changing priorities, handle multiple tasks simultaneously, and maintain composure under pressure while meeting deadlines and performance expectations. This position requires the ability to sit and work at a computer for extended periods of time. The employee must be able to focus on tasks involving prolonged screen time and perform repetitive motions such as typing and mouse use in a standard office environment. Regular phone communication is an essential part of this role. The employee must be able to make and receive calls as part of their daily responsibilities, communicate effectively and professionally, and provide accurate information in a clear and courteous manner.
Risk Strategies is an equal opportunity workplace and is committed to ensuring equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, Veteran status, or other legally protected characteristics. Learn more about working at Risk Strategies by visiting our careers page: www.risk-strategies.com/careers.
Personal information submitted by California applicants in response to a job posting is subject to Risk Strategies' California Job Applicant Privacy Notice.
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