Claim Adjuster

Full Time
Jersey City, NJ 07306
Posted
Job description
Company Description


We help the world see new possibilities and inspire change for better tomorrows. Our analytic solutions bridge content, data, and analytics to help business, people, and society become stronger, more resilient, and sustainable.


Job Description


We are looking for a candidate with a demonstrated mastery of EDI claims compliance reporting to jurisdictions and for IAIABC Claims Standards for all IAIABC Claims Releases 1, 2, 3.0 and 3.1. This knowledge is required to support our internal staff, our external clients and for the continuous improvement of systems and processes.

  • Your daily work will be directly related to the general business operations of the division and its customers. You will be responsible for helping manage clients and client activities, by using an interactive ticketing system.
  • You will assist in the management of the product backlog and corresponding product roadmap.
  • Manage junior level Business Analysts and provide training and guidance to enhance their development and capabilities as fully functioning business analysts
  • You will provide support to staff and clients on the IAIABC Claims Standards all current Releases 1, 2, 3.0 and 3.1.
  • You will provide client support for wcPrism Transactional Reporting and FROI SROI reporting products for new client implementations, existing client maintenance, serve as working meeting host and will provide other various client support processes.
  • You will provide support to clients to identify data reporting issues from their system, wcPrism or state system(s).
  • You will provide specifications/information needed for wcPrism system changes to comply with IAIABC standards changes and state requirement changes for IAIABC standards to have these changes implemented into wcPrism systems and reporting plan.
  • You will work closely with our customers and our product engineering team to ensure client satisfaction and timely delivery of services.
  • You will also be tasked with extensive research and analysis of customer data and regulatory requirements.
  • You will confirm the client to state reporting capabilities including associated setup processes such as profile updates among others.
  • You will monitor state acceptance criteria and make recommendations for wcPrism changes.
  • You will be responsible for keeping divisional management apprised of customer issues during and after integration as well as providing updates regarding account progress and potential red flags.
  • As a critical member of the product management team, you will need to continuously review our internal processes and procedures to ensure that they meet the needs of our clients.

Qualifications
  • College degree, preferably in Business Administration
  • At least 5 years of experience in Workers Compensation claim reporting required
  • Comprehensive knowledge of IAIABC Claims standards required
  • Data Reporting Experience required
  • Data Analysis/Research Skills required
  • Existing relationships with state accident boards preferred
  • Customer Service/Project Management skills preferred
  • Excellent troubleshooting ability required
  • Excellent oral/written communication and interpersonal skills required
  • Proficiency in Microsoft Office equivalent required

#LI-MB1


Additional Information


In 2022, Verisk received Great Place to Work® Certification for our outstanding workplace culture for the sixth year in a row and second-time certification in the UK, Spain, and India. We’re also one of the 38 companies on the UK’s Best Workplaces™ list and one of 18 companies on Spain’s Best Workplaces™ list.

For over fifty years and through innovation, interpretation, and professional insight, Verisk has replaced uncertainty with precision to unlock opportunities that deliver significant and demonstrable impact. From our historic roots in risk assessment, we’ve grown to provide analytic insights that help transform industries focused on some of the world’s most critical areas. Today, the insurance industry relies on Verisk to be, and to make the world, more productive, resilient, and sustainable.

Verisk works in collaboration with our customers and at the intersection of people, data, and advanced technologies. Through proprietary platformed analytics, advanced modeling, and interpretation, we deliver immediate and sustained value to our customers and through them, to the individuals and societies they serve, with greater speed, precision, and scale.

We’re 9,000 people strong, committed to translating big data into big ideas. We help others see new possibilities and empower certainty into big decisions that impact individuals and societies. And we relentlessly and ethically pursue innovation to help move our customers, and the world, toward better tomorrows.

Everyone at Verisk—from our chief executive officer to our newest employee—is guided by The Verisk Way, to Be Remarkable, Add Value, and Innovate.
  • Be Remarkable by doing something better each day in service to our customers and each other
  • Add Value by delivering immediate and sustained results that drive positive outcomes
  • Innovate by redefining what’s possible, embracing challenges, and pushing boundaries

Verisk Businesses

Underwriting Solutions — provides underwriting and rating solutions for auto and property, general liability, and excess and surplus to assess and price risk with speed and precision

Claims Solutions — supports end-to-end claims handling with analytic and automation tools that streamline workflow, improve claims management, and support better customer experiences

Property Estimating Solutions — offers property estimation software and tools for professionals in estimating all phases of building and repair to make day-to-day workflows the most efficient

Extreme Event Solutions — provides risk modeling solutions to help individuals, businesses, and society become more resilient to extreme events.

Specialty Business Solutions — provides an integrated suite of software for full end-to-end management of insurance and reinsurance business, helping companies manage their businesses through efficiency, flexibility, and data governance

Marketing Solutions — delivers data and insights to improve the reach, timing, relevance, and compliance of every consumer engagement

Life Insurance Solutions – offers end-to-end, data insight-driven core capabilities for carriers, distribution, and direct customers across the entire policy lifecycle of life and annuities for both individual and group.

Verisk Maplecroft — provides intelligence on sustainability, resilience, and ESG, helping people, business, and societies become stronger

At Verisk you can build an exciting career with meaningful work; create positive and lasting impact on business; and find the support, coaching, and training you need to advance your career. We have received the Great Place to Work® Certification for the 7th consecutive year. We’ve been recognized by Forbes as a World’s Best Employer and a Best Employer for Women, testaments to our culture of engagement and the value we place on an inclusive and diverse workforce. Verisk’s Statement on Racial Equity and Diversity supports our commitment to these values and affecting positive and lasting change in the communities where we live and work.

Verisk Analytics is an equal opportunity employer.

All members of the Verisk Analytics family of companies are equal opportunity employers. We consider all qualified applicants for employment without regard to race, religion, color, national origin, citizenship, sex, gender identity and/or expression, sexual orientation, veteran's status, age or disability.

http://www.verisk.com/careers.html

Unsolicited resumes sent to Verisk, including unsolicited resumes sent to a Verisk business mailing address, fax machine or email address, or directly to Verisk employees, will be considered Verisk property. Verisk will NOT pay a fee for any placement resulting from the receipt of an unsolicited resume.

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