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About the role
Key responsibilities & impact- Analyze and verify insurance coverage for claims brought against policyholders
- Assure timeliness and adequacy of reserves on claim files; approve or recommend adjustments
- Assign losses to claim staff for disposition
- Evaluate liability, damages, and causation; approve settlements within authority
- Advise Claims leadership on claims status and attend Reserve & Settlement Committee Meetings
- Determine work procedures, manage schedules, and expedite workflow
- Maintain and develop claims policies and procedures
- Coordinate services with other departments for insureds and clients
- Conduct quarterly audits of consultant case files
- Monitor staff, identify and implement training needs, and ensure compliance with claims handling requirements
- Track results, recommend improvements, and participate in strategic planning
- Manage assigned staff, including evaluations, time off, time cards, recognition, and disciplinary issues
- Monitor trials as necessary
- Assist in developing claims-related marketing strategies and tools for client retention and new business cultivation
Requirements
What you’ll need- Bachelor's degree (B. A.) from four-year college or university
- 8 years’ experience in handling medical malpractice claims or heavy bodily injury claims preferred
- A minimum of 3 years of supervisory/management experience
- Broad knowledge of medicine and familiarity with legal concepts and trends in litigation
- Knowledgeable in insurance policy contracts, particularly medical malpractice and general liability
- Formal nursing and/or legal education is a plus, but not required