Claims Representative II, Professional Liability

California Dental Association • Sacramento, CA

1d • $74,200 - $92,700 • Remote

About The Position

The Dentist Insurance Company (TDIC) is seeking a Claims Representative II, Professional Liability to join their team. This role is a remote-first position with occasional travel and in-office meetings, with a preference for candidates in California, Oregon, Washington, and Nevada. TDIC is dedicated to protecting dentists and has grown to protect over 24,000 policyholders across 15 states with a comprehensive suite of dentist-centric insurance products and risk management tools. The company has a strong financial rating and high client satisfaction, earning endorsements from nine dental associations. TDIC values diversity, collaboration, and a forward-thinking work environment, inviting individuals to be part of their innovation and growth.

Requirements

• High school diploma or GED.
• A minimum of three years insurance experience in a liability claims or similar position; or equivalent combination of education and experience.
• Experience in professional liability and/or general liability.
• General knowledge of state laws, insurance codes and principles, and the applicable Civil Codes, Health and Safety Codes.
• Excellent interpersonal, verbal and written communication skills.
• Intensive communication with involved parties via phone.
• Must be able to perform job duties under supervision.
• Excellent written and verbal communication skills necessary to effectively communicate and/or negotiate with policyholders, claimants, attorneys, and independent adjusters.
• Must maintain confidentiality.
• Must demonstrate diplomacy and tact while interacting with all levels within and outside of the organization.
• Ability to organize and prioritize case load.
• Computer skills, including the ability to operate MS Windows Office, including experience with AS400 or other database management program.
• Regular auto/air travel required.

Nice To Haves

• Associate’s or Bachelors’ degree with courses in insurance preferred.
• Commercial property insurance and in-person negotiation experience preferred.
• Experience with claims management and estimating software programs preferred.

Responsibilities

• Working with supervisor to identify, evaluate and make determinations on issues related to coverage.
• Working under close supervision to investigate and make determinations related to cause and origin of loss and liability, including retaining and supervising outside adjusters, legal counsel and other vendors, to ensure efficient adjustment of claims.
• Working with the claims supervisor to continually evaluate and establish appropriate case values and reserves.
• Working with claims supervisor to manage the course of litigation including, the development of defense strategies and budgets in accordance to TDIC Litigation Guidelines.
• Attending meetings with policyholders, defense attorneys, and consultants.
• Attending trials, mediations, and settlement conferences with supervisor approval.
• Negotiating claim resolutions with claimants and/or their legal representatives under the direction of the claims supervisor.
• Negotiating resolutions with policyholders and identify, manage, and resolve all issues related to subrogation of claims with the assistance of the supervisor.
• Maintaining assigned caseloads on a diary system, including, documenting claim files and timely corresponding with insureds, vendors, claimants and/or their legal representatives.
• Reviewing vendor bills, challenging billed items when appropriate and with supervisor guidance, approving payments.
• Reviewing new claims with the supervisor to determine an appropriate course of action.
• Identifying cases of significance with the assistance of the supervisor, and preparing appropriate requests for authority from supervisor, management, and/or the Board.
• Attending mandatory meetings and pursuing educational opportunities, including seminars, insurance courses, workshops, and in-house training, with approval from the claims supervisor.

Benefits

• Remote and hybrid flexibility and technology to support remote work
• Generous time off program starting at 22 days of PTO and 13 paid holidays (includes a floating holiday and winter closure)
• Highly competitive medical, dental and vision plans, including FSA and HSA account options
• 401(k) plans, with a generous match and safe harbor contributions upon eligibility
• Paid parental leave
• Wellness programs, including incentives and an In-Shape Family Fitness discount
• Opportunities for professional development, training and leadership skill-building
• Critical illness, accident, life, pet, short term and long-term disability insurance options
• Employee Assistance Program (EAP) for support navigating day-to-day challenges

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED