Complex Claims Specialist

We are seeking an experienced specialist to manage high-exposure medical professional liability claims. This role is designed for a technical expert who can navigate complex litigation and indemnity strategies while maintaining a high level of service for our insured clients. You will manage significant files from investigation through resolution, acting as a mentor to junior staff and a strategic partner to our underwriting and legal teams. Responsibilities Strategic File Management: Lead the investigation and documentation of high-severity claims, ensuring accurate indemnity and expense reserving. Litigation Oversight: Actively manage outside defense counsel to develop and execute effective litigation strategies; attend trials and mediations as the company representative. Resolution & Negotiation: Design creative resolution strategies and lead complex negotiations to bring sensitive matters to a close. Departmental Partnership: Collaborate closely with Underwriting on market-facing initiatives and maintain strong relationships with key stakeholders. Mentorship: Serve as a technical resource and mentor for less experienced claims professionals, fostering a culture of continuous learning. Operational Excellence: Maintain impeccable data integrity and documentation protocols in alignment with industry best practices. Required Skills Education: Bachelor’s degree is required; Juris Doctor (JD) is highly preferred for the Complex-level designation. Experience: Minimum of 6+ years of professional claims handling experience. Regulatory: Ability to obtain a New York Adjuster’s License within the first year of employment. Communication: Exceptional business writing and oral presentation skills, with the ability to explain complex legal or medical concepts to diverse audiences. Logistics: Must be able to work on-site during the initial onboarding period and travel as required for trials and mediations. Preferred Skills & Experience Industry Focus: Direct experience in Medical Malpractice (MedMal) is strongly preferred. Legal Background: We welcome MedMal Attorneys (JDs) looking to transition into a corporate claims environment, provided there is a demonstrated commitment to the shift in career path. Analytical Mindset: Strong ethical judgment and the ability to work independently on highly confidential, high-stakes matters. Who Should NOT Apply? Please note that our team focuses specifically on bodily injury and professional liability within the medical field. At this time, we are not considering candidates whose primary experience is in: Auto Insurance / No-Fault Schedule/Shift We believe in a balance of collaboration and flexibility. This position starts as a fully on-site role to ensure seamless integration into our culture. Once up and running, the role transitions to a hybrid schedule (3 days in-office, 2 days remote). Location: Hybrid (Roslyn, NJ, or Rochester) – 3 days in-office / 2 days remote Employment Type: Full-Time, Direct Hire Hybrid after ramping up to a full caseload and passing internal audits. Timeline depends on individual and their experience - should be roughly 6 months. #J-18808-Ljbffr