Complex Claims Specialist
Primma LLC
**This role is onsite at our Roslyn, NY, Rochester, NY, or Hamilton, NJ office, with the option for a hybrid schedule after the training period. ** General Summary: A Complex Claims Specialist will possess experience in handling complex medical liability claims, while demonstrating a strong client service focus.
Essential Duties & Responsibilities:
Essential Duties & Responsibilities:
- Follow standard claims protocols for documentation, coverage verification, and file management
- Maintain accurate and organized claims files, suggesting improvements as necessary.
- Manage significant client relationships for claims department, collaborate with underwriting on marketing.
- Investigate and document most significant exposures, setting appropriate indemnity and expense reserves
- Develop resolutions strategy and lead negotiations and bring matters to a close
- Attend trials and mediations when necessary
- Adhere to industry Best Practices for effective claim management
- Mentor staff through formal and informal training and development; demonstrate extensive technical expertise to guide and support less experienced claims professionals
- Ensure exceptional data integrity
- Actively manage defense council and partner on litigation strategy
- Proactive communication with insureds, other departments and claim leadership
- Perform additional duties and responsibilities as assigned
- Bachelor's degree or JD required
- Six years' claims handling experience required; medical professional liability strongly preferred
- NY adjusters license required within the first 6 - 12 months of employment
- Strong analytical and problem-solving skills with attention to detail
- Demonstrate solid and concise business writing proficiency
- Exhibit strong oral communication skills to include presenting information clearly and effectively to diverse audiences
- Ability to work independently as well as assume a mentorship role within a team. Act as a strong example and resource for less experienced colleagues
- Strong ethical judgement and a commitment to maintaining confidentiality
- Must be able to work on site
- Travel required as needed; may include overnight travel
Vacancy posted 4 days ago
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