Claims Advisor, Professional Liability – E&O, D&O

This is a fully remote position, open to applicants in Connecticut, +38 more states.

📋 Description

• Analyze and manage complex or technically challenging D&O, EPL, and E&O liability claims.

• Conduct investigations and collect information to assess claim exposure.

• Oversee claims using action plans to achieve timely and appropriate resolutions.

• Execute or assign comprehensive investigations and generate investigation reports for new incidents, claims, and legal matters.

• Negotiate claim settlements within the designated authority limits.

• Calculate and assign reserves promptly and appropriately while monitoring their adequacy.

• Propose settlement strategies and present structured settlement proposals as necessary.

• Undertake coverage analysis and provide well-informed opinions and correspondence.

• Coordinate legal defense efforts, assign attorneys, support investigations, review attorney invoices, and ensure counsel's compliance with client guidelines.

• Employ cost containment strategies and collaborate with strategic vendor partnerships to minimize claim expenses.

• Detect and investigate opportunities related to fraud, subrogation, contribution, recovery, and case management.

• Represent the organization in depositions, mediations, and trial monitoring as required.

• Maintain communication regarding claim activity and processing with clients, fostering professional relationships.

• Ensure accurate documentation of claim files and correctness of claim coding.

• Refer cases to supervisors and management as appropriate.

• Delegate tasks and mentor other team members.

⛳️ Requirements

• A minimum of ten (10) years of experience in complex claims management or an equivalent combination of education and experience is required.

• A Masters or Juris Doctorate degree from an accredited institution is preferred.

• Necessary licenses as required.

• Preferred designations and/or licenses include Associate in Claims (AIC), Chartered Property and Casualty Underwriter (CPCU), Associate in Risk Management (ARM), and Associate in Insurance Claims (AIC).

• Comprehensive knowledge of relevant medical malpractice insurance principles and laws applicable to the line of business managed.

• Familiarity with recoveries, offsets and deductions, claim and disability duration, and cost containment principles, including medical management practices and Social Security application procedures as applicable.

• Extensive understanding and comprehension of insurance coverage.

• Expertise in claims related to errors and omissions, directors and officers, and/or cyber liability.

• Exceptional oral and written communication skills, including presentation abilities.

• Proficiency in PC applications, including Microsoft Office products.

• Strong analytical and interpretive skills.

• Excellent organizational capabilities.

• Outstanding negotiation skills.

• Good interpersonal abilities.

• Capability to function effectively in a team setting.

• Ability to meet or exceed Performance Competencies.

• Proficient in computer keyboarding.

• Clear hearing, vision, and speech abilities.

• Strong clear and conceptual thinking skills; excellent judgment and discretion; ability to meet deadlines.

🏝️ Benefits

• Medical insurance.

• Dental insurance.

• Vision insurance.

• 401k with matching contributions.

• Paid Time Off (PTO).

• Disability insurance.

• Life insurance.

• Employee assistance programs.

• Flexible spending or health savings accounts.

• Additional voluntary benefits.

• Emphasis on work-life balance.

• Supportive and caring company culture.

• Opportunities for career advancement.