Manage guest incident claims from intake to resolution, including investigation, risk assessment, and coordination with third-party administrators. Provide litigation support by organizing case files, tracking deadlines, and managing communications with outside counsel.
Risk Analyst
Key Responsibilities
Claims Administration & Risk Management
- Manage guest incident claims from intake through resolution, escalation, or litigation referral, ensuring timely investigation, documentation, evaluation, and follow-up.
- Conduct claim review, investigation, and risk assessment to identify exposure, escalation triggers, documentation gaps, and appropriate next steps.
- Collect, review, and analyze claim-related documentation, including incident reports, photographs, witness statements, receipts, communications, and other supporting materials.
- Evaluate guest incident claims for completeness, liability indicators, potential litigation concerns, policy application, and allocation applicability.
- Exercise sound judgment in determining when claims require escalation, additional investigation, management review, or litigation referral.
- Serve as a primary operational liaison between Legal, Risk, Operations, Guest Relations, third-party administrators, insurance partners, and outside counsel.
- Coordinate with third-party administrators on claim status, documentation needs, investigation follow-up, escalation, reserve or exposure concerns, and resolution strategy.
- Review TPA claim updates, assessments, and recommendations, and identify issues requiring additional action, escalation, or Sr. Manager review.
- Attend claim reviews with third-party administrators and support follow-up on action items, trends, and open issues.
- Monitor claim activity and proactively identify inconsistencies, missing information, recurring issues, or operational gaps that may impact claim handling.
- Review allocation disputes and provide recommendations based on Company policy, available documentation, supporting evidence, and established guidelines.
- Support oversight of claim handling expectations, escalation protocols, reporting requirements, and TPA performance.
- Maintain and update guest incident handling procedures, allocation guidelines, chargeback processes, claims administration materials, and related policies in partnership with the Sr. Manager.
- Identify trends in guest incidents, claim activity, recurring issues, or policy gaps and recommend operational or process improvements to reduce exposure and support risk mitigation.
- Assist in developing and implementing best practices related to claims handling, investigation standards, documentation requirements, escalation protocols, allocation management, and claim file maintenance.
- Support training, guidance, and communication efforts related to guest incident documentation, claim handling procedures, and claims administration processes.
- Other tasks as assigned by manager.
Litigation & Legal Operations Support
- Provide litigation support for escalated guest incident claims and related matters, including document preservation, file organization, case tracking, and coordination with internal partners and outside counsel.
- Ensure claim and litigation files are complete, accurate, organized, and maintained in claim and matter management systems.
- Coordinate with outside counsel and internal stakeholders regarding document collection, case updates, deadlines, and litigation support needs.
- Monitor litigation deadlines, milestones, follow-up items, and matter activity to support case management and litigation strategy.
- Maintain accurate matter management system updates, litigation records, claim notes, reporting fields, and supporting documentation.
- Process and review outside counsel and vendor invoices for accuracy, completeness, compliance, and appropriate coding.
- Support litigation reporting, claims metrics, audits, trend analysis, and other operational reporting for the Legal team.
- Identify and recommend efficiencies in claims administration, litigation workflows, documentation practices, reporting processes, and matter management procedures.
- Provide guidance and informal mentoring to less experienced team members as appropriate.
Qualifications
- 6+ years of experience in claims management, risk management, investigations, litigation support, insurance administration, legal operations, or a related environment.
- Strong understanding of claims handling practices, liability evaluation, risk assessment principles, litigation readiness, and claim documentation standards.
- Demonstrated ability to independently manage claims, competing priorities, sensitive matters, and complex workstreams with limited supervision.
- Experience working with third-party administrators, outside counsel, insurance partners, claims management systems, matter management systems, and cross-functional business stakeholders.
- Ability to interpret and apply policies, procedures, allocation guidelines, escalation protocols, and supporting documentation.
- Strong investigative, analytical, organizational, and problem-solving skills.
- Sound judgment and decision-making skills, particularly in sensitive, high-risk, or time-sensitive situations.
- Strong written and verbal communication skills, with the ability to communicate clearly and professionally with internal and external stakeholders.
- Ability to handle confidential and sensitive information with discretion and professionalism.
- Proficiency in Microsoft Office applications, including Outlook, Word, and Excel; experience with claims or matter management systems preferred.
Compensation Range: $67,000.00 - $92,125.00
Red Robin is an Equal Opportunity & E-Verify Employer