at Gallagher in Chicago, Illinois, United States
Job Description
Gallagher Bassett is the premier provider of global claims services, dedicated to exceptional customer service and demonstrably superior outcomes. GB helps people, teams and businesses overcome adversity and loss through the guiding expertise of over 5,000 claims professionals, all committed to going beyond expectations in the continuous pursuit of a better way.
Position Summary:
+ The AI Specialist role will be responsible for reviewing claims identified by our decision support Predictive Models. The specialist will analyze alerts and claims identified as at risk for extended duration, high medical cost, potential decreased medical treatment quality or the propensity for litigation. If the risk exists, the AI Specialist will need to review the claim file to determine the best course of action for the claim to a Resolution Manager to mitigate the risk identified. Written recommendations to Resolution Managers include a brief summary of why the resource is needed, what benefit the resource can offer and provide information to the Resolution Manager to use when discussing the mitigation plan with the client.
Essential responsibilities include:
+ Generating recommendations for GB’s Claims Operations by combining claims expertise with the output GB’s decision-support products (AI/predictive models).
+ Exercising proper judgment and decision making to analyze the claims exposure to determine the proper course of action to appropriately move the claim towards effective resolution, consistent with clients’ and corporate policies, GB best practices and in accordance with any statutory, regulatory and ethics requirements.
+ Documenting and communicating clear and concise recommendations to claims teams when intervention strategies may improve claim outcomes.
+ Ability to work at full case load capacity, managing daily assignments efficiently and effectively with excellent prioritization and organizational skills.
+ Communicating in a professional, positive and proactive manner.
+ Using metric-driven reporting tools to evaluate performance and identify problem areas in advance of them becoming service issues.
+ Working collaboratively across all internal departments including Claims Operations, Client Services, and Product/Analytics to drive effective application of decision-support products
Required:
+ High School Diploma
+ Minimum of 3 years related claims experience required
+ Appropriately licensed and/or certified in all states in which claims are being handled
+ Knowledge of accepted industry standards and practices
+ Computer experience with related claims and business software.
Preferred Requirements:
+ Bachelor’s degree
+ 5 or more years of workers’ compensation claims experience
+ Experience handling multiple jurisdictions, multi-level complexity of claims
+ Wide variety of industry experience
Work Traits:
+ Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges
+ Analytical skill necessary to make decisions and resolve issues inherent in handling of claims
+ Experience handling complex litigation matters and settlement negotiations of claims, as well as the ability to interpret related documents.
U.S. Eligibility Requirements:
+ Interested candidates must submit an application and resume/CV online to be considered
+ Must be 18 years of age or older or must demonstrate legal capacity to enter a contract
+ Must be willing to submit to a background investigation; any offer of employment is conditioned upon the successful completion of a background investigation
+ Must have unrestricted work authorization to work in the United States. For U.S. employment opportunities, Gallagher hires U.S. citizens, permanent residents, asylees, refugees, and temporary residents. Temporary residence does not include those with non-immigrant work authorization (F, J, H or L visas), such as students in practical training status. Exceptions to these requirements will be determined based on shortage of qualified candidates with a particular skill. Gallagher will require proof of work authorization
+ Must be willing to execute Gallagher’s Employee Agreement or Confidentiality and Non-Disclosure Agreement, which require, among other things, post-employment obligations relating to non-solicitation, confidentiality and non-disclosure
Gallagher offers competitive salaries and benefits, including: medical/dental/vision plans, life and accident insurance, 401(K), employee stock purchase plan, educational expense reimbursement, employee assistance program, flexible work hours (availability varies by office and job function) training programs, matching gift program, and more.
Gallagher believes that all persons are entitled to equal employment opportunity and does not discriminate against nor favor any applicant because of race, sex, color, disability, national origin, religion, creed, age, marital status, citizenship, veteran status, gender, gender identity / expression, actual or perceived sexual orientation, or any other protected characteristic. Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified applicant with a disability, unless the accommodation would impose an undue hardship on the operation of our business.
\#L1-TB1
Job: Claims
Organization: GB Overhead
Title: Artificial Intelligence Specialist
Location: Illinois-Chicago
Requisition ID: 94587
