Analyze complex or technically difficult medical malpractice claims.
Provide resolution of highly complex nature and/or severe injury claims.
Coordinate case management within Company standards.
Manage total claim costs while providing high levels of customer service.
Investigate and gather information to determine the exposure on the claim.
Conduct or assign full investigation and provide report of investigation.
Negotiate claim settlement up to designated authority level.
Calculate and assign timely and appropriate reserves to claims.
Recommends settlement strategies; brings structured settlement proposals as necessary.
Coordinates legal defense by assigning attorney and coordinating support for investigation.
Monitors counsel for compliance with client guidelines.
Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities.

Bachelor's degree from an accredited college or university preferred.
Licenses as required.
Professional certification as applicable to line of business preferred.
Six (6) years of claims management experience or equivalent combination of education and experience required.
In-depth knowledge of appropriate medical malpractice insurance principles and laws for line-of-business handled.
Excellent oral and written communication, including presentation skills.
PC literate, including Microsoft Office products.
Analytical and interpretive skills.
Strong organizational skills.
Excellent negotiation skills.
Good interpersonal skills.
Ability to work in a team environment.
Ability to meet or exceed Performance Competencies.

Senior Claims Specialist, Professional Liability, Medical Malpractice, Long Term Care

Key skills