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Job ID :
104277
Location :
Countrywide, Countrywide US
Level :
Experienced Professional
Job Category :
Data Science & Analytics
Description :

Where good people build rewarding careers.

Think that working in the insurance field can’t be exciting, rewarding and challenging? Think again. You’ll help us reinvent protection and retirement to improve customers’ lives. We’ll help you make an impact with our training and mentoring offerings. Here, you’ll have the opportunity to expand and apply your skills in ways you never thought possible. And you’ll have fun doing it. Join a company of individuals with hopes, plans and passions, all using and developing our talents for good, at work and in life.


Job Description

We’re looking for a highly motivated Claims Support & Process Sr. Consultant who can apply their expertise in PIP Med Pay Claim handling through industry knowledge, analysis, attention to detail,  innovative thinking, organizational, communication and project management skills to help deliver quality solutions for the Claims PIP & Med Pay Line Management Team. 

 

Role Responsibilities

 

Under limited supervision, this job is responsible for analyzing, developing, and delivering data and information tools to support and enhance Claim processes for one the PIP and Med Pay Casualty Claims Line of Business. This individual supports new initiatives and addresses current business pressures through:

 

The development of new measurements and analysis tools.
Analysis of reporting platforms and key performance indicators (KPI's) for opportunities and enhancements.
Development and delivery of data and reporting training and supports other members of the team using a variety of tools and applications
Collecting, manipulating and analyzing large quantities of data
Understanding the financial drivers of business results and using them to develop analyses and prioritize work
Creates advanced Business Objects queries and reports, utilizing complex variable creation, multiple queries and other advanced techniques.
Work with Managers to collaborate with business and project leaders to recommend, implement, track, and report on financial and business process improvements
Assist developing predictive models


Process Design / Improvement

Manages and conducts research of impact of industry and regulatory changes and/or current state Field processes, including Field visits, feedback sessions, and industry/competitive intelligence, to identify process gaps
Develops recommendations to address identified process gaps and designs process enhancements and/or new processes to address the issues and achieve desired business outcomes
Develops timelines, coordinates resources, and establishes check-in meetings to implement process enhancements and/or new processes
Engaged in process improvement implementation and communicates status to all stakeholders
Leads or acts as individual contributor to projects and manages team members and holds them accountable
Develops quality assurance processes and guidelines for various Field roles and vendors, which may include quality review forms, quality reporting, technical platform support, and audit standards
Provides trend and results analysis on quality assurance to leadership
Researches and responds, or reviews the research of others to respond, to Field inquiries made on a variety of questions, concerns, and topics
Shares subject matter expertise on a variety of subjects with Field and other Home Office partners on a daily basis
Collaborates with Home Office and cross functional groups on various projects and product changes involving the disciplines the role supports
Communicates changes in process and develops and provides vendor performance data
Oversees and coordinates the development of periodic training sessions and communication updates to the Field, including, but not limited to, job aids, home page alerts, claims and policy handling guidelines, script changes, process communications, and leader communications, including Field and Home Office directors and officers; may also facilitate training sessions.

Job Qualifications

•    Bachelor’s degree in related field
•    Experience in medical claims handling preferred, including coverage, medical treatment protocols, billing, pricing and management.  Certified Medical Bill Coder a plus.
•    Advanced knowledge in data acquisition and manipulation applications (MS Access, Business Objects, Excel)
•    Experience organizing hypotheses, results and analysis into an effective communication package (PowerPoint, Tableau)
•    Ability to quickly learn new programs and tools to support the team
•    Applies knowledge of analytical procedures to reconcile, manipulate, and recognize patterns of data
•    Strong analytical skills
•    Strong written and verbal skills
•    Applies highly advanced knowledge of insurance policy, coverage, and regulation
•    Applies highly advanced knowledge of claim processes, policies, procedures, claim systems, coverage, liability, and/or settlement, and adherence to applicable legal compliance standards
•    Applies highly advanced industry knowledge of first party medical claim handling practices, including best practices, to support the business unit
•    Applies highly advanced ability to leverage learned technical skills in support of team objectives
•    Applies highly advanced problem solving skills to continuously improve business outcomes
•    Ability to assist leadership in achieving business unit objectives
•    Applies highly advanced knowledge of training facilitation and coaching skills
•    Ability to investigate, evaluate and settle highly complex claims
•    Provides highly advanced individual decision making within authority limits
•    Works within highly complex assignments requiring specialized knowledge in breadth and/or depth in area of expertise


The candidate(s) offered this position will be required to submit to a background investigation, which includes a drug screen.

Good Work. Good Life. Good Hands®.

As a Fortune 100 company and industry leader, we provide a competitive salary – but that’s just the beginning. Our Total Rewards package also offers benefits like tuition assistance, medical and dental insurance, as well as a robust pension and 401(k). Plus, you’ll have access to a wide variety of programs to help you balance your work and personal life -- including a generous paid time off policy.

Learn more about life at Allstate. Connect with us on Twitter, Facebook, Instagram and LinkedIn or watch a video.



Allstate generally does not sponsor individuals for employment-based visas for this position.

Effective July 1, 2014, under Indiana House Enrolled Act (HEA) 1242, it is against public policy of the State of Indiana and a discriminatory practice for an employer to discriminate against a prospective employee on the basis of status as a veteran by refusing to employ an applicant on the basis that they are a veteran of the armed forces of the United States, a member of the Indiana National Guard or a member of a reserve component.

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It is the policy of Allstate to employ the best qualified individuals available for all jobs without regard to race, color, religion, sex, age, national origin, sexual orientation, gender identity/gender expression, disability, and citizenship status as a veteran with a disability or veteran of the Vietnam Era.

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