Licensed Complex Claims Specialist

Job Summary

A company is looking for a Complex Claims Specialist, Long-Term Care Professional Liability.

Key Responsibilities

• Manage Long Term Care and Miscellaneous Medical Facilities claims from initiation to resolution, including investigation, coverage analysis, and settlement negotiations
• Perform advanced coverage analysis and document claims thoroughly in the Claims Management System
• Oversee litigation processes, including managing outside counsel and coordinating clinical resources for expert testimony

Required Qualifications

• Bachelor's and/or advanced degree; J.D. is a plus
• 7+ years of claims/legal experience, with at least 2 years in a technical specialty preferred
• Healthcare claims experience is strongly desired
• Advanced knowledge of claims handling concepts and insurance regulations
• Must obtain and maintain an Adjuster's license