Players Health

Claims Specialist

• Maintain oversight of commercial claims including complex and litigated matters
• Perform second- and third-level reviews
• Validate coverage, liability, reserves, and settlement strategies
• Provide direction to TPAs, adjusters, and counsel
• Perform file audits and QC checkpoints, track SLAs, cycle times, litigation rates, and recoveries
• Support internal and external audit and develop remediation plans
• Conduct routine claims audits and quality reviews
• Develop and maintain claims dashboards to track trends, performance metrics, and program health
• Partner cross-functionally with Athlete Safety to share claims data, loss trends, and emerging risk insights
• Analyze claim outcomes across TPAs, jurisdictions, and programs to inform process improvements and underwriting insights
• Submit GL and A&H claims and manage ongoing communication with TPAs
• Support MGA financial and regulatory reporting, including carrier-specific and state-required submissions
• Lead data cleanup initiatives across MGA and claims systems to improve reporting accuracy
• Lead, mentor, and develop a growing team by establishing clear standards, workflows, and accountability

Senior Claims Analyst