The Bristal Assisted Living · 4 months ago
Insurance Claims Specialist
Ronkonkoma, NY
Full-time
Onsite
Mid Level
3+ years expThe Bristal Assisted Living is an organization focused on promoting a safe environment for residents and staff. The Insurance Claims Specialist will manage and oversee various types of claims, ensure compliance with regulations, and collaborate with the finance team to support the organization's financial health.
Health CareHospitalNon Profit
Responsibilities
Manage and oversee workers' compensation, EPLI, GL, and PL claims from initial reporting through resolution
Respond to inquiries and concerns regarding new and existing claims
Conduct timely and thorough investigations, coordinating with internal and external stakeholders, requesting/reviewing witness statements, video footage etc. and ensure all claims are accurately documented and supported
Collaborate with claim and broker partners, build and maintain strong relationships to ensure effective claims handling and dispute resolution
Maintain clear, consistent communication with Vice President of Risk Management, various team members, business partners, and other stakeholders regarding claims handling and their resolutions
Ensure all claims processes adhere to state regulations and company policies, maintaining compliance with industry standards
Prepare and maintain regular reports on claims status, costs, and outcomes for internal review and regulatory purposes
Monitor claim trends and identify risk mitigation opportunities
Coordinate with the finance team to ensure accurate claims invoicing, payment tracking, and budgeting
Support the finance team with forecasting and financial planning related to insurance claims and associated expenses
Work with finance team to place and monitor appropriate reserves and allocate funds
Analyze claims data to provide insights into claim trends, financial impact, and risk management strategies
Develop and maintain dashboards and reporting tools to communicate claims data with key stakeholders
Use data insights to recommend and implement improvements to claims processes and cost-saving initiatives
Work closely with VP of Risk Management, finance, HR, and community leadership teams to streamline claims processing and minimize organizational risk
Serve as a primary point of contact for insurance carriers, third-party administrators, and internal teams on claims-related matters
Provide regular updates to management on claims status, strategic initiatives, and risk trends
Educate team members and on-site staff about claim reporting procedures, documentation best practices, and risk mitigation strategies
Assist in training sessions on safety and risk prevention, fostering a culture of proactive incident management
Qualification
Required
3-5 years of experience in insurance claims management, preferably within the healthcare or assisted living industry
Associate's degree required
Excellent customer service skills
Strong analytical and problem-solving skills to investigate and diagnose claim driven issues
Aptitude to investigate complaints for facts and recommend resolutions in a timely manner
Exceptional interpersonal, verbal, and written communication skills
Proven customer relationship and conflict resolution skills
Ability to develop and maintain strong working relationships with internal and external parties
Strong attention to detail and accuracy in data entry and record keeping
Must be willing to travel to various community locations for meetings, investigations, and internal audits as required
Company
The Bristal Assisted Living
The Bristal Assisted Living
1001-5000 employees
Funding
Current Stage
Late StageRecent News
2025-08-29
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