Healthcare Claims Specialist

Job Summary

Managing moderately complex Healthcare Professional Liability claims with a focus on Long Term Care - Medical Malpractice, the fully remote Senior Claims Specialist will oversee the full claim life cycle, including coverage analysis, investigation, evaluation, and resolution while ensuring compliance with client expectations and regulatory requirements.

Key responsibilities

• Analyzes coverage and settles claims in Healthcare Professional Liability, specifically Long Term Care Claims
• Conducts thorough investigations to determine claims exposure and recommends settlement strategies
• Negotiates settlements with clients, attorneys, and Public Adjusters while preparing reserve and settlement authority requests

Required qualifications

• Bachelor's Degree and 5+ years of related claims experience
• Prior experience in the applicable specialty claims area or ability to handle unique claims issues
• Appropriately licensed or able to obtain necessary licenses/certifications
• Knowledge of industry standards and practices related to claims processing
• Computer experience with claims and business software