Claims Systems Research Manager

Description

 

Analyzes and evaluates existing claims computerized and manual systems and procedures to improve efficiency; researches, develops, and recommends techniques for converting manual operations to computerized systems; and coordinates and participates in Joint Application Design (JAD) sessions for Claims projects.

The Claims System Research Managers main focus is to manage system changes that touch the electronic claims file application (CRN) and act as a liaison between the Field Claims Operations and the Application IT department. Responsibilities include managing the electronic claims file application (CRN) change control process including: creating business requirements, developing and reviewing test plans, performing demonstrations of the new changes, and validation of the final product. Additionally, the position assists the project managers in managing larger projects to completion.

Essential Job Functions

Analyzes and evaluates existing claims systems and procedures, and recommends methods of improvement.

Makes detailed systems studies of various departmental operations to improve operational efficiency; and develops and recommends solutions to improve manual processes.

Researches, develops, and pre-tests new methods and procedures as to feasibility of improving or converting manual processes to computerized systems.

Designs and develops flowcharts of proposed procedures.

Initiates forms design and revisions as needed for new systems.

Coordinates installation of equipment, data lines, satellite communications, telephone voice lines, back-up systems, and peripheral equipment for new and relocating Field Claims Offices.

Initiates requests for new and additional computer equipment for Field Claims Offices, and tracks status of delivery/installation.

Develops and maintains Field Claims Office computer and peripheral equipment inventories.

Requests GENS, LUs, and TCTs, for new computer equipment.

Develops, writes, and distributes correspondence, procedures, and training material pertaining to methods and processes in the Field Claims Offices.

Coordinates and participates in Joint Application Design (JAD) sessions for Claims projects with

Members of Home Office Claims staff.

Maintains contact with outside vendors of office technology.

Attends conferences, seminars, and demonstrations to maintain an awareness of emerging office technologies.

Performs other duties as assigned.

Physical Demands

Bending Pulling Sorting

Carrying up to 20 lbs. Pushing Speaking (English)

Climbing Reaching Standing

Key entering Reading (English) Walking

Kneeling Seeing Writing (English)

Physical Environment

Required job duties are normally performed in a climate-controlled office environment.

Education Requirements

Four-year college degree. Completion of, or actively pursuing a major insurance designation, or actively pursuing insurance related courses.

Experience and Special Skills Requirements

Experience Requirements

External candidates should have a minimum of three years of prior claims experience. The same time-on-job requirement is preferred for internal candidates.

Special Skills Requirements

Communication Skills

Personal Computer Literate

Valid driver's license