Complex Claims Specialist

Primma, LLC•Roslyn, NY

3d•Hybrid

About The Position

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.

Requirements

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

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