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

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee and manage executive, errors and omissions, and intricate professional liability claims.

• Address highly complex and/or severe injury claims.

• Coordinate case management adhering to company standards, industry best practices, and client service expectations.

• Control total claim costs while delivering exceptional customer service.

• Analyze and address complex or technically challenging liability claims through thorough investigation of claim exposure.

• Conduct or delegate comprehensive investigations and produce investigation reports for new incidents, claims, and legal matters.

• Negotiate claim settlements up to the designated authority level.

• Timely calculate and assign appropriate claim reserves.

• Propose settlement strategies.

• Execute coverage analysis and provide opinions.

• Oversee legal defense by assigning attorneys, supporting investigations, reviewing attorney invoices, and ensuring compliance with client guidelines by counsel.

• Implement cost containment techniques and leverage strategic vendor partnerships to minimize claim costs.

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

• Represent the company during depositions, mediations, and trial monitoring as necessary.

• Communicate claim activities and processing updates to clients.

• Ensure proper documentation of claim files and accuracy of claim coding.

• Refer cases to supervisors and management when appropriate.

⛳️ Requirements

• A minimum of ten (10) years of experience in complex claims management, or a comparable blend of education and experience.

• A Master's degree or Juris Doctorate from an accredited institution is preferred.

• Licenses as necessary.

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

• Comprehensive knowledge of medical malpractice insurance principles and relevant laws.

• Understanding of recoveries, offsets and deductions, claim and disability duration, and cost containment strategies.

• Extensive knowledge and understanding of insurance coverage.

• Expertise in claims related to errors and omissions as well as directors and officers insurance.

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

• Proficiency in PC operations, including Microsoft Office applications.

• Strong analytical and interpretive capabilities.

• Exceptional negotiation skills.

• Capability to work effectively within a team environment.

• Ability to meet or surpass performance competencies.

• Competence in performing computer keyboarding tasks.

• Adequate hearing, vision, and verbal communication abilities.

• Strong conceptual thinking ability, sound judgment and discretion, and capacity to meet deadlines.

🏝️ Benefits

• Medical, dental, and vision insurance.

• 401k plan with matching contributions.

• Paid time off (PTO).

• Disability and life insurance coverage.

• Employee assistance program.

• Flexible spending accounts or health savings accounts.

• Additional voluntary benefits available.

• Emphasis on work-life balance.

• Supportive workplace culture.