About The Position

As a member of the Professional Risk Management Services (PRMS) Claims unit, the Senior Litigation Specialist will investigate, evaluate, negotiate, and resolve claims as assigned. This individual will be responsible for the overall accuracy, promptness, and efficiency of technical outcomes on medical professional liability claim files which involve advanced complexity and exposure.

Requirements

  • 4+ years evaluating or investigating medical malpractice claims with a major insurance carrier or TPA
  • JD strongly preferred
  • Technical knowledge of insurance coverage and policies, insurance law, tort law, and claims handling practices
  • Highly developed skills in negotiation, analysis, problem-solving, and decision-making
  • Ability to perform effectively under pressure in high-complexity, high-risk situations and adapt rapidly to changing conditions
  • Excellent written and verbal communication skills

Nice To Haves

  • Adjuster's and P&C licenses are a plus
  • Insurance designations (AIC, ARM, CPCU, ALCM) are a plus

Responsibilities

  • Evaluating insurance contracts and making coverage decisions
  • Developing, coordinating, and documenting claims and litigation strategies
  • Managing reserves and overall loss costs on assigned files
  • Negotiating high-value claims and resolving complex cases
  • Managing defense and panel counsel, ensuring adherence to PRMS's Litigation Guidelines
  • Maintaining compliance with all internal, legal, and regulatory requirements
  • Upholding customer service quality standards in accordance with operating guidelines and internal procedures
  • Collaborating across PRMS and FAIRCO to provide timely claims analysis, guidance, and direction
  • Identifying, analyzing, and assessing risks and trends in clinical practice areas
  • Meeting with insureds, defense counsel, and plaintiff attorneys to address claim issues, negotiate settlements, and attend mediations and trials
  • Traveling to meet with client program principals and attend client functions, as needed
  • Participating in special projects and initiatives, as assigned

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What This Job Offers

Job Type

Full-time

Career Level

Mid Level

Education Level

Ph.D. or professional degree

Number of Employees

251-500 employees

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