Senior Claims Examiner, Healthcare

Arch Capital Group•Chicago, NY

7d•Hybrid

About The Position

The Claims Division is seeking a highly experienced professional to join the Healthcare Claims Team as a Senior Claims Examiner. In this role, the examiner will be responsible for actively managing and effectively overseeing an assigned caseload of complex healthcare-related claims for hospitals, miscellaneous healthcare facilities and other healthcare providers.

Requirements

Bachelor’s degree required
3-7 years of work experience handling management liability claims process at a carrier, broker, or law firm
Exceptional communication (written and verbal), evaluation, influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines
Strong time management and organizational skills
Ability to take part in active strategic discussions
Ability to work well independently and in a team environment
Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word
Willing and able to travel 15-20%

Nice To Haves

Juris Doctorate degree preferred
Proper adjuster licensing in all applicable states preferred

Responsibilities

Identify and assess coverage issues, draft coverage position letters, and retain coverage counsel, when necessary as well as review coverage counsel's opinion letters and analysis
Develop and implement strategy relative to coverage issues which correlate with the overall strategy of matters entrusted to the handler's care
Develop and implement strategy to resolve matters of liability and damages of a particular case
Maintain contact with the claim staff, business line leaders, underwriters, defense counsel, and brokers
Investigate claim and review the insureds' materials, pleadings, and other relevant documents
Identify and review of each jurisdiction's applicable statutes, rules, and case law
Review litigation materials including depositions and expert's reports
Analyze and direct risk transfer, additional insured issues, and contractual indemnity issues
Retain counsel when necessary and direct counsel in accordance with resolution strategy
Analyze coverage, liability and damages for purposes of assessing and recommending reserves
Prepare and present written/oral reports to senior management setting forth all issues influencing evaluation and recommending reserves
Travel to and from locations within the United States to attend mediations, trials, and other proceedings relevant to the resolution of the matter
Negotiate resolution of claims
Review and evaluate defense counsel invoices for reasonableness and process associated payments
Maintain a diary of all claims, post reserves in a timely fashion, and expeditiously respond to claims inquiries from insured, counsel, underwriters, brokers, and senior management