Complex Claims Specialist

Complex Claims Specialist

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:

• 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

Education & Qualifications:

• 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

The actual compensation for this position will be determined by experience and other factors permitted by law.