Senior Claims Examiner, Healthcare

Position Summary The Claims Division is seeking a highly experienced professional to join the Healthcare Claims Team as a Senior Claims Examiner. In this role, the examiner will be responsible for actively managing and effectively overseeing an assigned caseload of complex healthcare-related claims for hospitals, miscellaneous healthcare facilities and other healthcare providers. Responsibilities Identify and assess coverage issues, draft coverage position letters, retain coverage counsel when necessary, and review coverage counsel’s opinion letters and analysis. Develop and implement strategy relative to coverage issues which correlate with the overall strategy of matters entrusted to the handler’s care. Develop and implement strategy to resolve matters of liability and damages of a particular case. Maintain contact with claim staff, business line leaders, underwriters, defense counsel, and brokers. Investigate claims and review the insured’s materials, pleadings, and other relevant documents. Identify and review each jurisdiction’s applicable statutes, rules, and case law. Review litigation materials including depositions and expert reports. Analyze and direct risk transfer, additional insured issues, and contractual indemnity issues. Retain counsel when necessary and direct counsel in accordance with resolution strategy. Analyze coverage, liability and damages to assess and recommend reserves. Prepare and present written or oral reports to senior management setting forth all issues influencing evaluation and recommending reserves. Travel to and from locations within the United States to attend mediations, trials, and other proceedings relevant to the resolution of the matter. Negotiate resolution of claims. Review and evaluate defense counsel invoices for reasonableness and process associated payments. Maintain a diary of all claims, post reserves in a timely fashion, and expeditiously respond to claim inquiries from insured, counsel, underwriters, brokers, and senior management. Experience & Required Skills 5-7 years of work experience handling management liability claims process at a carrier, broker, or law firm. Exceptional communication (written and verbal), evaluation, influencing, negotiating, listening, and interpersonal skills to develop productive working relationships with internal and external peers and other professionals across organizational lines. Strong time management and organizational skills. Ability to take part in active strategic discussions. Ability to work well independently and in a team environment. Hands‑on experience and strong aptitude with Microsoft Excel, PowerPoint and Word. Willing and able to travel 15‑20%. Education Bachelor’s degree required; Juris Doctorate degree preferred. Proper adjuster licensing in all applicable states preferred. Compensation and Benefits Salary ranges: NY, NJ: $123,400 – $191,628 per year. IL: $111,100 – $172,465 per year. Position is incentive‑eligible. Benefits include multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401(k) with generous matching; 20 days PTO per year; up to 12 paid company holidays plus 2 paid days of volunteer time; basic Life and AD&D insurance and short‑ and long‑term disability; paid parental leave up to 10 weeks; student loan assistance and tuition reimbursement; backup child and elder care; and more. #J-18808-Ljbffr McNeil & Co.