Overview In this role you manage highly complex medical malpractice claims with significant exposure, coordinating across internal teams and experts to verify coverage, investigate, and develop resolution strategies. You will lead investigations, establish reserves, and collaborate with counsel to manage litigation and settlements while maintaining high service standards. The position emphasizes proactive risk management, regulatory compliance, and timely, accurate claim handling. You'll work with cross-functional partners to drive efficient resolutions and keep leadership informed on major risks and losses. This role offers the opportunity to shape outcomes in a specialized professional liability领域,
Compensation / Benefits- Medical, dental & vision
- 401(k) retirement plan
- Life insurance (voluntary)
- Short and long-term disability
- Health Spending Account (HSA)
- Paid time off (PTO)
Responsibilities- Manage an inventory of complex professional liability claims following company protocols
- Verify coverage and establish reserves with policy interpretation and, when needed, coverage counsel
- Lead investigations to determine compensability, liability and damages with relevant documents and witnesses
- Develop and execute claim resolution strategies in collaboration with internal and external partners
- Oversee reserves, budgets, and timely payments while ensuring high-quality service
- Identify subrogation/salvage opportunities or fraud indicators and refer for investigation
- Maintain claims documentation, ensure adherence to protocols, and resolve/pay claims timely
- Prepare loss summaries and concise leadership briefings on risks and losses
- Ensure regulatory compliance and maintain SME knowledge of commercial insurance laws and trends
- May perform additional duties as assigned
Key requirements- Bachelor's degree or equivalent experience
- CA Certification required
- 3-5 years claims experience
- Professional designations preferred
- Solid knowledge of claims and insurance industry practices
- Strong interpersonal, communication, and negotiation skills
- Ability to work independently and meet deadlines
- Analytical and problem-solving capabilities
- Proficiency with Microsoft Office Suite and related software
- Ability to adapt to change and value diverse perspectives
- Ability to articulate analyses in internal reports
- Independent judgment in evaluating claims and making cost-benefit decisions
- Interpersonal finesse
- Effective communication
- Negotiation
- Microsoft Office Suite
- Claims handling knowledge
- Regulatory compliance awareness
