Claims Specialist

Our client is currently seeking a Claims Specialist to handle professional liability claims for all product lines.

Responsibilities:

• Working under the general supervision of the senior claims leader and acting within authority appropriate for this position, the claims handler is expected to:
• The primary responsibilities of this position are to investigate, evaluate and resolve medical claims. The position requires handling claims across varied medical specialties.
• Conducts investigations to gather evidence and facts sufficient to make appropriate decisions including obtaining review of medical records and expert opinions.
• Reviews coverage and seeks consultation on coverage issues; evaluate liability and damages; determines appropriate course of action for case resolution. Makes decisions and takes action within authority.
• Obtains written consent from insureds; negotiates settlements; utilizes appropriate methods, such as mediation, ADR, and structured settlements.
• Evaluates reserves per company guidelines.
• Secures satisfactory results and timely closures.
• Works closely with defense counsel to establish litigation plan of actions and budgets.
• Presents claims at internal claim roundtables.
• Attending mediations, court conference and trials. 

Preferred Candidates:

Should possess strong knowledge of relevant legal decisions, claim trends and industry practices

Requirements:

• 5-10 years medical malpractice or equivalent claims experience.
• Proficiency with Excel, Word and demonstrated aptitude with Windows based operating systems