Claims Specialist

Claims Specialist Our client is seeking a Claims Specialist to manage medical malpractice claims for their Orange County office. This role involves handling technical and administrative responsibilities for highly complex claim files, participating in litigation processes, and providingguidance and oversight to junior team members. The ideal candidate is detail-oriented, highly organized, and experienced in managing large caseloads with significant financial exposure. This is a 100% onsite role. Key Responsibilities: Claims Management & Oversight Manage assigned medical malpractice claims, including directing defense counsel under supervision Investigate, evaluate, and document claim files in compliance with company standards Prepare case evaluation reports for internal review and discretionary authority Monitor litigation progress, including discovery, mediation, MSC, trials, and arbitrations Documentation & Reporting Maintain timely updates in claims databases and OnBase document management system Document all important case developments under the chronology tab Prepare claim file resolution documentation Training & Team Support Assist management in training Claims Specialist I and II staff Provide guidance on coverage issues and special projects Member & Attorney Interaction Interview members and correspond with plaintiff attorneys as necessary Obtain preliminary expert opinions and prepare interview summaries Take hotline calls and prepare reports as requested Required Qualifications: Bachelor's degree Minimum five years of medical malpractice claims experience or three years CAP claims experience Valid California driver license Strong analytical, communication, and time-management skills Ability to handle multiple priorities and deadlines Work Details: Hours per week: 40 Expected Start Date: Dec 29, 2025