Claims Research and Reporting Analyst

Berkshire Hathaway Homestate Companies, Workers Compensation Division, has an immediate opening for a Claims Research and Reporting Analyst. This team member will train closely with the Claims Research Supervisor to develop a basic understanding of multi-jurisdictional filing requirements, system usage, and transmittal expectations to ensure timely compliance and data integrity in mandatory reporting.  This individual will build knowledge of applicable regulatory requirements and proper claims handling procedures for assigned jurisdictions to perform updates to the company’s internal, online resource utilized by Adjusting staff.  Assignment of jurisdictions will increase as proficiency is demonstrated.  Demands high attention to detail to ensure accuracy and thoroughness, along with ability to master basic coding (HTML).  

ESSENTIAL RESPONSIBILITIES

• Trains closely with Supervisor to develop a basic understanding of Electronic Data Interchange (EDI) filing requirements for assigned jurisdictions, to include familiarization with IAIABS and state implementation guidelines, event tables, edit matrixes, element requirement tables and sequencing tables.
• Reviews incoming Peak and State reports, identifies basic reoccurring errors which require correction and timely completes same within company Claims system. 
• Performs daily review of basic manual filings and generates appropriate notifications to team member and within Claims system. 
• Works with vendors to remove claims from sequencing as directed by Supervisor.
• Completes EDI manual filings, ensuring data is complete and accurate and report is successfully transmitted timely.  Achieves goal acceptance rate for jurisdiction with minimal rejections.    Completes other State or workflow reviews and reports as needed to ensure compliance and data integrity.   
• Evaluates State report cards and suggests technological and process improvements.  Identifies and suggests training to increase productivity and compliance timeliness.  

• Trains closely with Supervisor to understand standard processes for team and resource tool, as well as accepted operating procedures/industry standards for claims management and benefit administration for assigned jurisdictions.  Audits existing resource content and researches basic case law as needed to ensure accuracy and thoroughness of content for assigned jurisdiction.   
• Utilizes resource administrative functions to rearrange material, update material, or identify and propose changes to system display.  Organizes and summarizes proposed revisions to Supervisor and/or Claims management for approval.  
• Builds network of State contacts and information repositories to effectively confirm legal interpretations of compliance standards by State officials, representatives, and defense counsel. 
• Intakes and reviews basic research requests.  Works with team members and Supervisor to complete requests in a timely manner utilizing various research tools (e.g., LexisNexis).  Cohesively and concisely summarizes various caselaw, statutes and legal opinions applicable to request. 
• Builds and maintains open lines of communication with relevant Adjusting staff to encourage inquiries and feedback and facilitate timely reporting and maintenance of compliance standards.  

• Performs other related duties or special projects as assigned by company leadership or as situation dictates. 

• EDUCATION: High School diploma or equivalent certificate required; Bachelor’s degree in Business Administration, Technical Communication, or related field, from an accredited college or university, and/or Paralegal certification from accredited program, preferred.
• CRITICAL THINKING: Ability to think critically and adapt quickly in a flexible and dynamic environment.  Proactive and inquisitive in approach to work. Ability to derive appropriate conclusions and apply on the job
• MATH AND REASONING ABILITY: Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.
• LANGUAGE ABILITY: Ability to read and interpret complex documents including statutes, regulations, legal opinions, legal letters, medical records, medical bills, medical resource materials, investigation reports, claim notes, and claim data fields. Ability to write clear, concise notes accurately conveying basic and technical information.  Ability to effectively present information and respond to questions with interdepartmental partners and leaders both in individual conversations and presentations to groups.

• Minimum of one year of experience conducting/summarizing legal research, or equivalent training, highly preferred.
• Prior HTML coding experience/reference material design preferred.
• Prior workers compensation claim handling experience, preferably within a multi-jurisdictional  carrier, a plus.

• Basic skill in Microsoft Office applications required
• Ability to rapidly master the use of proprietary software applications required
• Speedy data entry ability with minimal error occurrence required
• Basic knowledge of HTML coding preferred

• Expertise in legal research, including use of LexisNexis, and proficiency in maintaining database of materials, is preferred
• Familiarity with insurance (preferably within workers compensation space) and applicable terminology, regulatory requirements, and industry best practices, a plus  

• Work-Life Balance
• Modern Office Setting
• Free On-Site Fitness Facility
• Free downtown shuttle route
• Two-minute walk from Walnut Creek BART Station
• Three-minute car ride from CA-24 and I-680
• Free On-Site Garage Parking

• Paid Time Off
• Paid Holidays
• Retirements Savings Match
• Group Health Insurance (Medical, Dental, and Vision)
• Life and AD&D Insurance
• Long Term Disability Insurance
• Accident and Critical Illness Insurance
• Flexible Savings Accounts
• Paid Community Volunteer Day
• Employee Assistance Program
• Tuition Reimbursement Program
• Employee Referral Program
• Diversity, Equity and Inclusion Program

ABOUT US

With more than 50 years in business, BHHC has grown from a regional organization to a national insurance group, offering insurance products from coast to coast. Relationships are the cornerstone of our culture, and we believe in doing the right thing. That means we invest in our business in every way possible to deliver on our mission and demonstrate that people are what powers our success. Our commitment to financial strength and integrity means our customers can rest assured that we will be there when it counts.

At BHHC we embrace diversity and foster an environment where our people can be their authentic selves. Our differences make us stronger and better together, which fosters a harmonious workplace—something we truly value. We’ve created an approachable and collaborative atmosphere. Here you’ll find a welcoming workplace where everyone can feel valued, supported, and inspired to do great work. Together, we raise the bar by being curious, remaining customer-focused, and operating with integrity.