Senior Claims Examiner, Healthcare

Berkshire Hathaway Specialty Insurance•Atlanta, GA

2h•$120,000 - $150,000•Onsite

About The Position

Berkshire Hathaway Specialty Insurance (BHSI) is a strategic and trusted insurance partner providing a broad range of commercial property, casualty, and specialty insurance coverages globally. As part of Berkshire Hathaway’s insurance operations, BHSI leverages its strong brand, top-rated balance sheet, and a global team of expert professionals. The organization is values-based, emphasizing respect, integrity, excellence, collaboration, and passion, and fosters an inclusive environment that values diversity. BHSI is seeking an experienced claims professional to join its growing team in Chicago, Atlanta, Boston, or New York. This role is suitable for practicing lawyers looking to transition from a law firm or claims professionals with healthcare claims experience. The Healthcare Senior Claims Examiner will handle and adjust all facets of Senior Care and Healthcare claims in a highly collaborative team environment, dedicated to best-in-class claims handling.

Requirements

High degree of specialized and technical competence in the handling of claims.
5-10 plus years of healthcare claim handling experience or matching equivalency.
College degree required.
Ability to work independently and assimilate learning materials on many different subjects from various sources.
Excellent interpersonal, communication and negotiation skills.
Ability and willingness to work effectively in a team environment and handle multiple tasks simultaneously.
Experience in handling and adjusting claims in multiple jurisdictions and must possess, or be willing to obtain, required licenses.

Nice To Haves

JD preferred.

Responsibilities

Manage and adjust healthcare claims impacting primary, umbrella and excess policies while ensuring the highest level of customer service and technical claim file quality.
Proactively handle claims from first notice of loss through ultimate resolution while working with and advising internal partners and meeting with clients and brokers.
Ongoing collaboration and partnership with the insured, broker and TPA in the handling and adjudication of claims.
Analyze and draft coverage letters as appropriate and communicate coverage positions effectively.
Conduct, coordinate, and proactively handle the investigation process and ensures timely resolution of claims.
Direct and closely monitor assignments to experts and defense counsel as necessary.
Evaluate information on coverage, liability and damages to determine the extent of exposure to the insured and the company.
Draft reports set reserves within the authority or make claim recommendations concerning reserve changes.
Travel to conferences, mediations, and trials as necessary.