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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 compensation structure with potential for bonuses based on performance
- Comprehensive benefits package that supports employee well-being
- Collaborative work environment with autonomy to influence outcomes
- Opportunity to work on high-severity claims with a significant impact on the organization
- Flexibility with in-office requirements based on candidate location
What to Expect (Job Responsibilities):
- Manage MMF/LTC Professional Liability Claims from first notice through resolution, including investigation and liability evaluation
- Perform advanced coverage analysis and prepare clear coverage opinions
- Document claims thoroughly using the Claims Management System and maintain follow-up actions
- Oversee outside defense counsel and manage litigation strategy for claims
- Collaborate with regulatory and compliance teams to incorporate developments into case strategy
What is Required (Qualifications):
- Minimum 7 years of claims/legal experience with substantive handling of MMF and/or LTC Professional Liability claims
- Advanced knowledge of professional liability coverage interpretation and complex issues
- Strong litigation management experience, including oversight of defense counsel and cost control
- Practical understanding of clinical issues and relevant regulatory landscape in LTC/MMF
- 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
- Ability to present complex clinical and coverage positions to various stakeholders
#Insurance #ClaimsManagement #CareerOpportunity #ProfessionalLiability #Collaboration
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