Senior Claims Specialist - Healthcare Professional Liability - Correctional Medicine

Gallagher•Houston, TX

11d•Remote

About The Position

The Claims Specialist within GB Specialty manages moderately complex Healthcare Professional Liability claims, primarily focused on Correctional Medicine. The role oversees the full claim life cycle, including coverage analysis, investigation, evaluation, and resolution, while ensuring claims are handled in accordance with client expectations, policy obligations, and regulatory requirements. The position is fully remote and open to any jurisdiction. The incumbent must be willing to obtain all required licenses within designated timeframes. Salary could be up to $110,000 per year, dependent upon experience. The role generally does not handle workers’ compensation claims. It requires working at full caseload capacity under minimal supervision and applying claims-processing knowledge, insurance fundamentals, and a basic understanding of correctional medicine professional liability terminology and case law.

Requirements

Bachelor’s degree required.
Minimum 2+ years of experience handling professional liability claims.
Strong insurance fundamentals and understanding of claims processes.
Ability to analyze documentation, summarize facts, and support coverage and liability determinations.
Computer proficiency with claims systems and standard business software.
Must be able to obtain required adjuster licenses within designated timeframes.
Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, and communicate effectively in writing and verbally.
Strong analytical skills to support claims decisions and issue resolution.
Ability to interpret policies, records, and related documentation.

Nice To Haves

Prior experience in healthcare, medical malpractice, or correctional medicine claims.
Strong insurance background, including carrier, TPA, brokerage, or claims support experience.
JD preferred but not required.

Responsibilities

Analyze coverage and settle moderately complex Correctional Medicine Professional Liability claims.
Manage the full life cycle of assigned claims files.
Analyze coverage and determine defense obligations.
Conduct thorough analysis and investigations to determine claims exposure and recommend settlement strategies and action plans.
Create reservation of rights and coverage denial letters.
Negotiate settlements with clients, client attorneys, and Public Adjusters.
Interact with parties involved in the claims process and recommend retaining outside experts when necessary.
Prepare reserve and settlement authority requests for client and carrier approval.
Act as a client advocate with carriers to support proper claims handling, including scoping, estimating, and coverage matters as needed.
Handle claims consistently with client and corporate policies, procedures, and best practices, and in accordance with statutory, regulatory, and ethical requirements.
Manage a full caseload.