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Risk Claims Analyst
The University of Kansas Health System. Provides support to the Risk, Claims, and Insurance Department in physician risk, claims administration, and the insurance program .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in risk management, claims administration, and insurance program support within a healthcare environment. Proficient in data analysis, report preparation, and effective communication with various stakeholders.
Highest-signal resume keywords
Risk ManagementClaims AdministrationInsurance Program SupportData AnalysisMicrosoft Office Suite
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims ManagementStatistical ReportingUnderwriting RequestsDatabase ManagementDocument Preparation
Soft Skills
Critical ThinkingProfessional JudgmentCommunicationCollaboration
Tools & Technologies
Microsoft Office WordMicrosoft ExcelMicrosoft PowerPointMicrosoft Outlook
Certifications & Qualifications
Technical/Professional Designations in RiskClaims or Insurance
Industry Keywords
Healthcare EnvironmentRisk Management IssuesClaims TrendsPatient RelationsConfidential Documentation
About the role
Key responsibilities & impact- Provides support to the Risk, Claims, and Insurance Department in physician risk, claims administration, and the insurance program
- Conducts research and prepares statistical reports
- Handles underwriting requests and assists with obtaining insurance renewal data
- Processes new claims, ensuring timely and accurate reporting
- Represents department management when communicating with hospital executives, vendors, physicians, staff, and community agencies
- Supports insurance renewals, certificate of insurance coordination, provider coverage changes, and refund tracking
- Supports general liability, property, and auto claims, including claim coordination
- Coordinates responses to litigation discovery and documents matter activities and correspondence in a database
- Escalates claim concerns to the team
- Composes, edits, proofs, assembles, and distributes correspondence, reports, policies, website content, and other documentation
- Prepares reports, activity calendars, and mass mailings
- Assists with database structure, data gathering and analysis, and report distribution
- Prioritizes, reviews, classifies, and files confidential correspondence and documentation
- Assists with development, implementation, and monitoring of the claims management program
- Participates on Patient Relations committees, including Grievance and Appeal committees
- Promotes safe and quality patient care and reduces liability exposure
- Facilitates prompt and compassionate claims management using professional judgment and critical thinking
- Coordinates development and presentation of educational programs on risk management issues and claims trends
- Promotes containment of claims and losses through early identification, assessment, and resolution
- Acts as liaison between the Board of Healing Arts and UKP physicians regarding complaints
- Assists with early communication and resolution protocols following unanticipated negative outcomes of care
- Works with Compliance, Risk Management, and other departments on claims and insurance information
- Participates in education and orientation of new physicians
Requirements
What you’ll need- Associate's Degree from an accredited College or University
- 5 or more years broad administrative/project coordination/ or risk, insurance, and claims management in a healthcare environment
- Demonstrated competencies in Microsoft Office Word, Excel, PowerPoint, and Outlook, as well as other intra/internet programs
- Preferred: Bachelor's Degree from an accredited College or University
- Preferred: Technical/Professional designations and training in Risk, Claims or Insurance/Degree in Business School Training
- Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department
Benefits
Comp & perks- Equal employment opportunity employer
- Reasonable accommodations for qualified individuals with disabilities