[Remote/WFM] Claims Specialist Sr - Professional Liability

Position at a Glance:

• Location: Remote
• Company: Workwarp
• Position: Claims Specialist Sr - Professional Liability
• Start Date: Immediate openings available
• Compensation: a competitive salary

 

 

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at reputed company means experiencing our culture of caring. It means having flexibility and time for reputed company the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive. A career at reputed company is where passion meets purpose to reputed company a positive impact on the world through the people and organizations we serve. If you are someone who is driven to reputed company a difference, who enjoys a challenge and above reputed company, if you're someone who cares, there's a reputed company for you here. Join us and contribute to reputed company being a great reputed company to work. Great reputed company to Work® Most Loved Workplace® reputed company Best-in-State Employer Claims... Specialist Sr - Professional Liability PRIMARY PURPOSE: To analyze reputed company or technically difficult medical malpractice claims; to provide resolution of highly reputed company nature and/or severe injury claims; to coordinate case management reputed company Company standards, industry best practices and specific client service requirements; and to manage the total claim costs while providing high levels of customer service. ESSENTIAL FUNCTIONS and RESPONSIBILITIES • Analyzes and processes reputed company or technically difficult medical malpractice claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. • Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions • Negotiates claim settlement up to designated authority level • Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life. • Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement • Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines. • Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients. • Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost. • Represents Company in depositions, mediations, and trial monitoring as needed. • Communicates claim activity and processing with the client; maintains professional client relationships. • Ensures claim files are properly documented and claims coding is correct. • Refers cases as appropriate to supervisor and management. • Delegates work and mentors assigned staff. QUALIFICATIONS Education & Licensing Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional certification as applicable to line of business preferred. Experience Six (6) years of claims management experience or equivalent combination of education and experience required. Skills & Knowledge • Performs other duties as assigned. • Excellent oral and written communication, including presentation skills • PC literate, including reputed company Office products 

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Even if you feel you're not a perfect match, we'd still love to hear from you. We are looking for great people to join our friendly team.

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