Professional Liability Claims Advisor

This is a fully remote position, open to applicants in Arizona, +5 more states.

📋 Description

• Oversee and manage MedMal and professional liability claims.

• Resolve claims that are highly complex and/or of significant severity.

• Coordinate case management in line with company standards, industry best practices, and client service expectations.

• Control total claim costs while delivering exceptional customer service.

• Investigate and process claims that are complex or technically challenging.

• Create action plans to ensure timely and appropriate resolution of claims.

• Conduct or delegate comprehensive investigations and provide detailed investigation reports.

• Negotiate claim settlements up to the designated authority limit.

• Calculate, assign, and monitor reserves for claims.

• Suggest settlement strategies and present structured settlement proposals as needed.

• Conduct coverage analysis while providing opinions and necessary correspondence.

• Coordinate legal defense, assign attorneys, review attorney invoices, and ensure compliance from counsel.

• Implement cost containment strategies and leverage strategic vendor partnerships.

• Investigate potential fraud, subrogation, contribution, recovery, and case management opportunities.

• Represent the company in mediations and monitor trials as required.

• Communicate claim activities and processing updates to clients.

• Maintain professional relationships with clients.

• Ensure accurate documentation of claim files and correct coding.

• Refer cases to supervisors and management when appropriate.

• Delegate tasks and mentor team members.

⛳️ Requirements

• High School Diploma or GED is mandatory.

• A Bachelor's degree from an accredited institution is preferred.

• Professional certification relevant to the line of business is preferred.

• A minimum of 3-5 years of experience in medical malpractice and professional liability claims management is required.

• Availability during business hours in the Pacific Time Zone is necessary.

• Experience in handling complex Medical Malpractice and/or Professional Liability claims.

• Proven experience in investigating claims and assessing coverage.

• Capability to manage high-exposure files.

• Ability to collaborate effectively with defense counsel.

• Skills to mentor other team members.

• Strong analytical and conceptual thinking abilities.

• Excellent judgment, troubleshooting, problem-solving, and discretion skills.

• Capacity to handle work-related stress and manage multiple priorities simultaneously.

• Ability to meet deadlines consistently.

• Proficient in computer keyboarding.

• Willingness to travel as needed.

🏝️ Benefits

• Opportunities for professional development.

• Flexible work schedule.

• Referral incentive program.

• Chance to work in an agile environment.

• Career growth and promotional advancement opportunities.

• Medical, dental, and vision benefits starting on day one.

• 401K available from day one.

• 401K matching offered.

• Paid Time Off (PTO).

• Disability and life insurance coverage.

• Employee assistance program.

• Flexible spending or health savings account options.

• Additional voluntary benefits available.