Claims Specialist
About The Position
Our client is seeking a Claims Specialist for their Orange County office. This role involves handling technical and administrative responsibilities related to managing assigned claim files and taking on a larger caseload of highly complex claims. The Senior Claims Specialist also plays an active role in the ongoing training and oversight of Claims Specialist I and II team members. Job Summary We are seeking an experienced Claims Specialist to manage complex medical malpractice claims with increasing financial exposure. This role is responsible for overseeing the full lifecycle of claims, directing defense counsel, evaluating liability and exposure, supporting litigation activities, and ensuring compliance with internal guidelines and regulatory standards. Salary Range (California Pay Transparency) $110,000.00 – $130,000.00 per year. Actual compensation will be determined based on qualifications, experience, internal equity, and business needs.
Requirements
- Bachelor’s degree from an accredited four-year institution.
- Minimum five years of medical malpractice claims management experience or three years of CAP claims experience.
- Valid California driver’s license.
Responsibilities
- Manage medical malpractice claims in compliance with applicable manuals and agreements
- Investigate and evaluate claims, including medical record review and expert consultation
- Prepare case evaluation reports and litigation documentation
- Participate in discovery, mediation, MSC, and negotiations
- Monitor trials and arbitrations
- Maintain claims databases and documentation systems
- Identify and follow up on coverage issues
- Assist with training and special projects
- Perform other duties as assigned
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
