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Complex Claims Specialist, Miscellaneous Medical Facilities Professional Liability
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Job Description
- Req#: 72960
Employer Industry: Insurance
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Competitive salary with potential for bonuses based on performance
- Comprehensive benefits package including workplace flexibility and professional development opportunities
- Work in a collaborative environment with autonomy to influence outcomes
- Chance to shape claim strategy on high-severity matters and impact organizational policies
What to Expect (Job Responsibilities):
- Own and manage MMF/LTC Professional Liability Claims from first notice through resolution, including investigation and negotiation
- Perform advanced coverage analysis and prepare clear coverage opinions and reservation communications
- Document claims thoroughly using Claims Management System and manage follow-up actions and deadlines
- Manage litigation by overseeing outside defense counsel and directing discovery strategy
- Coordinate clinical resources and expert consultants for analysis and testimony
What is Required (Qualifications):
- Minimum 7 years of claims/legal experience with substantive handling of MMF and/or LTC Professional Liability claims
- Demonstrated advanced knowledge of professional liability coverage interpretation and complex coverage issues
- Strong litigation management experience, including cost control and oversight of defense counsel
- Practical understanding of clinical issues common to LTC/MMF and relevant regulatory landscape
- Bachelor's degree required; advanced degree is a plus
How to Stand Out (Preferred Qualifications):
- Experience managing high-severity, multi-claimant, or regulatory matters
- Proven analytical, negotiation, and communication skills, especially in complex clinical and coverage scenarios
#Insurance #ClaimsManagement #CareerOpportunity #ProfessionalDevelopment #EmployeeBenefits
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