Sr. Claims Specialist, Professional Liability

New

United StatesFull-TimeSenior

Salary87,497 - 129,000 USD per year

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Job Details

Experience: Six (6) years of claims management experience or equivalent combination of education and experience
Required Skills: Data AnalysisMicrosoft OfficeNegotiationRisk Management

6 years of claims management experience or equivalent education/experience combination.
In-depth knowledge of medical malpractice insurance principles and laws.
Knowledge of recoveries, offsets, deductions, claim/disability duration, and medical management cost containment.
Excellent oral and written communication, including presentation skills.
PC literacy including Microsoft Office products.
Strong analytical, interpretive, and organizational skills.
Excellent negotiation and interpersonal skills.
Ability to work effectively in a team environment.
Bachelor's degree from an accredited college or university preferred.
Professional certification applicable to the line of business preferred.
Possession of required state insurance licenses.

Analyze and process complex or technically difficult medical malpractice claims by investigating information to determine exposure.
Manage claims through well-developed action plans to ensure appropriate and timely resolution.
Conduct or assign full investigations and report on new events, claims, and legal actions.
Negotiate claim settlements up to designated authority levels.
Calculate and assign appropriate reserves and monitor reserve adequacy throughout the claim life.
Coordinate legal defense by assigning counsel, reviewing invoices, and monitoring for compliance.
Implement cost containment techniques and identify opportunities for fraud, subrogation, and recovery.
Represent the company in depositions, mediations, and trial monitoring.
Mentor assigned staff and delegate work as appropriate.

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