Senior Claims Examiner, Healthcare

Job Opportunity

At Berkshire Hathaway Specialty Insurance our claims professionals are an integral part of our business. Every claim is handled with the utmost skill by seasoned and dedicated claims professionals. We are seeking an experienced professional to join our growing team in the Chicago, Atlanta, Boston or New York office. This position is a great opportunity for practicing lawyers looking to transition out of a law firm as well as claim professionals with healthcare claims experience or matching equivalency.

In this role, the Healthcare Senior Claims Examiner will have a unique opportunity to handle and adjust all facets of Senior Care and Healthcare claims in a highly collaborative team environment dedicated to best in class claims handling.

Duties & Responsibilities

• Manage and adjust healthcare claims impacting primary, umbrella and excess policies while ensuring the highest level of customer service and technical claim file quality.
• Proactively handle claims from first notice of loss through ultimate resolution while working with and advising internal partners and meeting with clients and brokers.
• Ongoing collaboration and partnership with the insured, broker and TPA in the handling and adjudication of claims.
• Analyze and draft coverage letters as appropriate and communicate coverage positions effectively.
• Conduct, coordinate, and proactively handle the investigation process and ensures timely resolution of claims.
• Direct and closely monitor assignments to experts and defense counsel as necessary.
• Evaluate information on coverage, liability and damages to determine the extent of exposure to the insured and the company.
• Draft reports set reserves within the authority or make claim recommendations concerning reserve changes.
• Travel to conferences, mediations, and trials as necessary.

Qualifications, Skills and Experience

• High degree of specialized and technical competence in the handling of claims.
• 5-10 plus years of healthcare claim handling experience or matching equivalency.
• College degree required. JD preferred.
• Ability to work independently and assimilate learning materials on many different subjects from various sources.
• Excellent interpersonal, communication and negotiation skills.
• Ability and willingness to work effectively in a team environment and handle multiple tasks simultaneously.
• Experience in handling and adjusting claims in multiple jurisdictions and must possess, or be willing to obtain, required licenses.

BHSI Offers

• A competitive package and exciting growth opportunities for career-oriented teammates
• A dynamic, action oriented, and thoughtful environment centered on always doing the right thing for our customers, teammates, and our other stakeholders
• A purposely non-bureaucratic organization that embraces simplicity over complexity and emphasizes individual excellence in a team framework
• Benefits that support your life and well-being, which include:
• Comprehensive Health, Dental and Vision benefits
• Disability Insurance (both short-term and long-term)
• Life Insurance (for you and your family)
• Accidental Death & Dismemberment Insurance (for you and your family)
• Flexible Spending Accounts
• Health Reimbursement Account
• Employee Assistance Program
• Retirement Savings 401(k) Plan with Company Match
• Generous holiday and Paid Time Off
• Tuition Reimbursement
• Paid Parental Leave

The base salary range for this position is from $120,000.00 to $150,000.00, along with annual bonus eligibility; a candidate's salary is determined by their relevant skills and experience. We value our teammates – both their capabilities and character – as demonstrated by our amazing culture.

NOTE: Compensation will be commensurate with experience. This job description is not intended to be all-inclusive. Team Member may perform other related duties as negotiated to meet the ongoing needs of the organization.