Senior Medical Malpractice Claims Specialist

The Doctors Company•New York, NY

58d•$97,304 - $137,880•Hybrid

About The Position

Healthcare Risk Advisors is seeking a medical malpractice Senior Claims Specialist to join our claims team. This is a hybrid opportunity based out of New York City. This position is responsible for performing investigations, evaluations, negotiations, and settlements to equitably resolve claims for a major academic health system in the metropolitan NY area. Position conducts business with policyholders and others in a manner that achieves economy and upholds the company’s reputation for quality service. This position has contacts with employees, vendors, lawyers, and policyholders. This position works under immediate supervision.

Requirements

JD preferred. Bachelor’s degree required.
Adjusters license required
Minimum of 2-5 years as a claims adjuster, paralegal, attorney, or related experience.
Excellent interpersonal and organizational skills.
Strong knowledge of medical malpractice law.
Strong listening skills.
Strong negotiating skills.
Strong Microsoft Office Suite skills.

Responsibilities

Provides clear communication to client and follows up as necessary based on expectations agreed to with the client.
Maintains awareness of client’s needs and context of their communication in order to provide proper support.
Elevates concerns expressed by the insured client to management as necessary.
Provides excellent service to team members who submit requests to the team.
Provides high-quality, comprehensive work product that facilitates efficient/effective downstream workflow.
Identify and elevate ERM exposure.
Adhere to best practices.
Understands the venues, applicable law and reserving philosophy of HRA to properly evaluate the exposures contained within the assigned caseload.
Ensures effective documentation of established reserves.
Provides timely analysis of cases to establish appropriate reserves.
Escalate cases that are unique or unusual to leadership for evaluation, escalation, and communication as necessary.
Determines the proper course of resolution based on the directed investigation by assigned staff and makes recommendations to leadership accordingly.
Gives appropriate insight and advice to clients, staff and defense counsel on the best possible outcome for both the insured client and the company.
Completes coverage analysis and requests coverage review as appropriate.
Makes appropriate and decisive decisions to establish a plan of action on all cases assigned to the team.
Directs all reporting to High Exposure Committee and Reinsurers as necessary.
Makes recommendation for assignment of litigated matters to appropriate defense panel members based on ability and experience.
Partners with defense counsel for optimum outcome on all assigned cases.
Monitors and approves fees and expenses within authority to comply with company guidelines and state statutory guidelines.
Attends and monitors (directly or indirectly) settlement conferences, mediations and trials, reports out timely and insightfully, and escalates as needed.
Evaluates attorney work product/performance and advises supervisor of any need for corrective action or improvement.
Recommends the proper course of resolution timely to leadership and/or client based on the investigation and discovery.
Maintain technical knowledge and skills to efficiently and effectively support and advance the department strategic plan and goals.
Completes any training required to maintain or advance the skills set necessary to reach department and company goals.
Makes oneself available for any and all duties.
Accepts delegated tasks readily and completes assigned duties as directed.

Benefits

medical, family and bereavement leave
same-sex domestic partner benefits
short- and long-term disability programs
employee assistance program
Health, dental, and vision insurance
Health and dependent care tax-free spending accounts with a company match
401(k) and Roth IRA with company match, as well as catch-up plans for both
Paid vacation, sick days, and personal days each calendar year (with vacation increases based on length of service)
11 paid holidays each calendar year
Life and travel insurance
Tax-free commuter benefits
In-person and online learning opportunities
Cross-function career opportunities
Business casual work environment
Time off to volunteer
Matching donations to qualifying nonprofit organizations
Company-sponsored participation at non-profit events