Senior Claims Specialist, Professional Liability – Medical Malpractice

This is a fully remote position, open to applicants in Arizona, +4 more states.

📋 Description

• Evaluate intricate or technically challenging medical malpractice claims

• Facilitate resolution of highly complex and/or severe injury claims

• Oversee case management in accordance with company standards, industry best practices, and client service expectations

• Manage overall claim costs while delivering exceptional customer service

• Investigate claims and legal actions to assess claim exposure

• Create action plans for prompt claim resolution

• Calculate and allocate reserves, and monitor their adequacy

• Suggest settlement strategies and structured settlement proposals

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

• Implement cost containment strategies and strategic vendor collaborations

• Investigate opportunities related to fraud, subrogation, contribution, recovery, and case management

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

• Communicate claims activity with clients and foster professional client relationships

• Ensure claim files are accurately documented and claims coding is precise

• Refer cases to supervisors and management as necessary

• Support the organization's quality initiatives

• Carry out other assigned duties

⛳️ Requirements

• Minimum of 6 years of claims management experience or an equivalent combination of education and experience required

• Bachelor's degree from an accredited institution preferred

• Licenses as mandated

• Professional certification relevant to the line of business preferred

• Strong analytical and negotiation abilities

• Sound judgment and discretion

• Capability to meet deadlines

• Clear and conceptual thinking skills

• Proficiency in computer keyboarding

• Adequate hearing, vision, and verbal communication skills

🏝️ Benefits

• Work-life balance

• Caring culture

• Opportunities for career advancement

• Equal Opportunity Employer

• Drug-Free Workplace

• Diverse, equitable, and inclusive work environment