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Complex Claims Specialist, Miscellaneous Medical Facilities Professional Liability
5 days agoWhat's your preference?
Job Description
- Req#: 73379
Employer Industry: Insurance
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Work in a collaborative environment with autonomy to influence outcomes and policy
- Comprehensive benefits and workplace flexibility
- Involvement in high-severity claims and complex litigation management
- Chance to work with clinical resources and expert consultants
- Competitive salary with potential for bonuses based on performance
What to Expect (Job Responsibilities):
- Own and manage Miscellaneous Medical Facilities Professional Liability Claims from first notice through resolution
- Perform advanced coverage analysis and prepare clear coverage opinions
- Document claims thoroughly using the Claims Management System and track follow-up actions
- Manage litigation by overseeing outside defense counsel and controlling budgets
- Collaborate with underwriting, reinsurance, and subrogation on claims and recovery opportunities
What is Required (Qualifications):
- Minimum 7 years of claims/legal experience with substantive MMF Professional Liability claim handling
- Advanced knowledge of professional liability coverage interpretation and complex coverage issues
- Strong litigation management experience, including oversight of outside defense counsel
- Practical understanding of clinical issues 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 written/verbal communication skills
- Familiarity with CMS surveys and state rules related to long-term care
#Insurance #ClaimsManagement #CareerOpportunity #ProfessionalDevelopment #InclusiveCulture
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