Forensics - Claims Processor - Analyst

In today's landscape, the claims processing environment is increasingly influenced by the complexities of natural disasters and the regulatory frameworks that govern them. The need for efficient and accurate claims assessment has evolved beyond mere processing to encompass quality control, timely resolution, and effective communication across various stakeholders. As a Claims Processor on our team, you will play a pivotal role in delivering exceptional service to our clients by utilizing the latest technologies and methodologies to ensure thorough evaluations of claims. You will be at the forefront of addressing the challenges posed by high volumes of claims while maintaining a focus on integrity, privacy, and efficiency. This position offers significant opportunities to collaborate with diverse stakeholders and leverage innovative tools to enhance the claims experience for those affected by disasters.

The opportunity  

EY’s Forensic & Integrity Services team is seeking dedicated and detail-oriented Claims Processors to join our team. In this role, you will be instrumental in evaluating claims related to a large natural disaster, ensuring that all submissions are complete and accurate. Your keen eye for detail and commitment to integrity will help facilitate a smooth and timely claims process. You can expect to assist with evaluating and resolving claims, which will provide experience in the insurance and utility industries. As part of this engagement, you will be expected to spend one week per month on-site at the client’s office in Los Angeles, California.

Your key responsibilities

As a Claims Processor, you will play a crucial role in evaluating claims related to a large natural disaster for completeness and accuracy. Once claims are assigned, you will conduct initial assessments of the submitted documents and identify any gaps or discrepancies that may require further information and attention. Your responsibilities will include documenting findings and determining the appropriate next steps for each claim, facilitating a smooth and timely claims process. You will collaborate with team members to escalate issues and resolve claims, all while maintaining a strong focus on the integrity of the process.

Skills and attributes for success

• Take responsibility for high-quality execution and delivery of claims assessments and documentation.
• Develop yourself and others through seeking and offering on-the-job coaching and feedback.
• Manage a large volume of claims, ensuring that all work aligns with the client’s requirements.
• Nurture relationships with colleagues and stakeholders to foster collaboration and effective communication.
• Maintain a strong focus on the claims process and be responsive to internal and external requests.

To qualify for the role you must have

• Must have a Juris Doctorate degree, and a minimum of one year of relevant work experience in the document review field

• Excellent project and time management
• The ability to work in a fast-paced environment with the ability to adapt to client’s needs
• Proficiency with Microsoft Outlook, Excel, and Word
• Excellent client-facing and internal verbal and written communication skills
• Excellent project and time management skills and the ability to prioritize when working on multiple claims
• The ability and willingness to travel up to 25%, which includes one week per month to the client site in California
• The ability and willingness to travel and work in excess of standard hours when necessary
• Access to reliable transportation to/from the EY office and client sites. A driver's license is strongly recommended as ride share and public transportation options may not be available in all locations

Ideally, you’ll also have

• Experience with conducting document review on industry standard document review hosting platforms.
• Experience with the insurance claims process

What We Look For

We seek dedicated individuals who are passionate about the claims process and possess the intellectual curiosity to navigate the complexities of evaluating claims in the aftermath of a natural disaster. A strong background in claims processing, attention to detail, and the ability to assess documentation accurately are essential. However, we are not just looking for technical proficiency; we value individuals who can build and nurture relationships with colleagues and stakeholders, demonstrating a commitment to understanding our clients' needs thoroughly. If you are eager to join a collaborative team where your contributions will have a meaningful impact on the claims experience for those affected, this role is the perfect opportunity for you.