About this role

Manages an inventory of highly complex commercial claims, with large exposures
Coordinates all claim resolution activities in accordance with company protocols
Achieves exceptional customer service by managing all aspects of the claim
Verifies coverage and establishes timely and adequate reserves
Leads focused investigation to determine compensability and liability
Resolves claims by collaborating with internal and external business partners
Establishes and manages claim budgets
Realizes and addresses subrogation/salvage opportunities or potential fraud occurrences
Achieves quality standards by managing each claim appropriately
Keeps senior leadership informed of significant risks and losses
Maintains subject matter expertise and ensures compliance with state/local regulatory requirements
Mentors, guides, develops and delivers training to less experienced Claim Professionals

Bachelor's Degree or equivalent experience
Typically a minimum six years of relevant experience, preferably in claim handling
Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable
Prior negotiation experience
Professional designations preferred (e.g. CPCU)

Complex Claims Consultant, Healthcare

Key skills