Senior Claims Examiner, Medical & Healthcare Claims

Responsibilities Handles healthcare malpractice/negligence claims. Analyzes coverage and communicates coverage positions; drafts coverage position letters; confirms coverage of claims by reviewing policies and documents submitted. Conducts, coordinates, and directs investigations into loss facts and extent of damages; evaluates information on coverage, liability, and damages to determine insurer’s exposure. Manages claims in all jurisdictions, including litigated and non‑litigated bodily injury claims up to $450,000, overseeing the process from inception to conclusion (settlement, trial, or appeal). Monitors excess and reinsurance claim files with varying attachment points. Identifies losses to be reported to SIU. Participates in special projects or assists other team members as requested. Provides excellent and professional customer service to insureds while maintaining a high level of production. Represents Markel in mediations; monitors trials as required. Sets reserves within authority or recommends reserve changes to manager. Education Bachelor’s degree or equivalent work experience. JD, advanced degree, or focused technical degree a plus. Certification Must have or be eligible to receive a claims adjuster license. Successful achievement of industry designations (INS, IEA, AIC, ARM, SCLA, CPCU) or participation in industry training opportunities (CLM Claim College, Munich Re Training, FDCC, etc.). Work Experience Minimum of 7–15 years of claims handling experience or an equivalent combination of education and experience in insurance. Successful completion of 5 years as a Claims Examiner. Skill Sets Excellent written and oral communication skills. Strong analytical and problem‑solving skills. Strong organizational and time‑management skills. Experience in negotiation, mediations, arbitrations, and monitoring trials on higher‑value complex claims. Ability to influence claims stakeholders and direct claims strategy. Strong vendor management skills, including guidance to defense attorneys, independent adjusters, consultants, forensic accountants, and other experts while controlling expenses. Ability to provide technical training to team claim handlers as required. Well developed expertise in technically complex claims topics. Policy language skills enabling accurate and consistent policy wording interpretation. Experience in following up on recommendations from technical claims audits and continuous file‑handling improvement. Ability to deliver outstanding customer service. Intermediate skills in Microsoft Office (Excel, Outlook, PowerPoint, Word). Ability to work in a team environment. Strong desire for continuous improvement. US Work Authorization US Work Authorization required. Markel does not provide visa sponsorship for this position, now or in the future. Pay Information Base salary $73,600–$107,250 with 15% bonus potential, based on education, experience, licensure, and other factors. Benefits Competitive benefit programs supporting life at home and work. Health, dental, and vision insurance plans; optional life, disability, and AD&D insurance. 401(k) with employer match; Employee Stock Purchase Plan. PTO, corporate holidays, floating holidays, and parental leave. Markel is an equal opportunity employer. We do not discriminate on the basis of any protected characteristic, including race, color, sex, religion, creed, national origin, ancestry, age, disability, sexual orientation, gender expression, genetic information, pregnancy, marital status, veteran status, and others as defined by applicable law. #J-18808-Ljbffr