Lead Claims Specialist, HPL

Tokio Marine HCC

. Manage hospital professional liability, general liability, auto, and managed care claims for the Excess Healthcare line of business .

Posted 10/14/2026full-timeAlpharetta • United StatesSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing hospital professional liability claims, including investigation, negotiation, and regulatory compliance. Proficient in developing claims systems and processes while mentoring less experienced adjusters and ensuring effective communication with stakeholders.

Highest-signal resume keywords

Bachelor's Degree In Business AdministrationState Adjusting Licenses6 Years Of Experience In Medical Professional Liability ClaimsStrong Decision-Making And Problem-Solving SkillsIntermediate To Advanced Proficiency In Microsoft Office

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ManagementCoverage EvaluationSettlement NegotiationClaims InvestigationRegulatory ReportingReport DraftingClaims System DevelopmentLoss Runs ReviewAudit ConductingResource Assignment

Soft Skills

Exceptional CommunicationAnalytical SkillsFlexibility And AdaptabilityMentoring And TrainingProblem-Solving Aptitude

Tools & Technologies

Microsoft ExcelMicrosoft AccessMicrosoft PowerPointMicrosoft Word

Certifications & Qualifications

State Adjusting Licenses

Industry Keywords

Hospital Professional LiabilityGeneral LiabilityManaged Care ClaimsExcess HealthcareContinuous ImprovementRisk ManagementInsurance

About the role

Key responsibilities & impact

Manage hospital professional liability, general liability, auto, and managed care claims for the Excess Healthcare line of business
Investigate coverage and evaluate liability and damages
Resolve claims, including negotiating settlements
Proactively oversee all aspects of claims to minimize company risk of loss
Analyze and draft coverage letters and communicate coverage positions to insureds, brokers, and agents
Conduct proactive claim investigations and maintain a diary applying best practices
Set timely reserves and draft concise reports to leadership when authority is exceeded
Assign, direct, and monitor outside counsel and vendors
Negotiate claim settlements and attend court hearings, mediations, settlement conferences, and trials
Complete required regulatory reporting
Mentor and educate less experienced adjusters
Represent TMHCC at industry conferences as necessary
Conduct insured audits and loss runs reviews and produce reports to senior leadership
Aid in developing claims systems and processes
Develop work plans, establish timelines, set goals, assign resources, and meet deadlines
Communicate team or work unit results and recommendations to management and clients
Improve business processes and assist with implementing new processes
Ensure work is thorough, cost-efficient, and productive
Comply with corporate policies and procedures and report control breakdowns
Plan, conduct, and supervise assignments; train personnel and assign work
May assist with reviewing and evaluating assigned personnel

Requirements

What you’ll need

Bachelor’s degree in business administration, risk management and/or insurance
State Adjusting Licenses required
6 years of relevant and progressive experience in handling medical professional liability claims throughout the United States
Knowledge of effective and efficient methods, with a focus on continuous improvement and innovation
Sound analytical skills, strong decision-making and problem-solving aptitude
Exceptional communication and ability to make connections externally and internally
Flexibility and willingness to learn and adapt to new developing processes, systems, and procedures
Excellent written and verbal communication skills with an emphasis on confidentiality, tact, and diplomacy
Intermediate to advanced proficiency and experience using Microsoft Office package (Excel, Access, PowerPoint, Word)
Regular travel availability of up to 50% of time
State adjusting licenses must be held
Passport not required
Driver’s license not required

Benefits

Comp & perks

Competitive salary and comprehensive medical, vision, and dental benefit package, with eligibility beginning on your date of hire
Strong learning culture with ongoing development opportunities
Basic life and disability insurance
401(k) plan with 6% company match
20 days of PTO
Two floating holidays
Approximately 11 paid holidays
Volunteer time off
Paid parental leave
Opportunity to do meaningful work and love what you do