Sr. Claims Examiner/Executive Claims Examiner, Medical Malpractice

Markel • Plano, TX

119d • $97,520 - $134,090

About The Position

This position will be the acknowledged technical expert and be responsible for the resolution of high complexity and high exposure claims. The position will have significant responsibility for decision making and work autonomously within their authority. This position will be an acknowledged technical expert and be responsible for the resolution of complex and high exposure Healthcare claims with an emphasis on the excess and reinsurance business, and higher limits primary/stacked limits.

Requirements

• Bachelor’s Degree required
• Juris Doctor optional
• Must have or be eligible to receive claims adjuster license
• Successful achievement of industry designations (INS, IEA, AIC, ARM, SCLA, CPCU) or I-Lead or other Management Training
• 7-10+ years of claims handling experience or equivalent combination of education and experience
• Experience handling high exposure bodily injury healthcare claims

Nice To Haves

• Market leading specialist knowledge within healthcare lines
• Expert policy language skills enabling accurate and consistent policy wording interpretation
• Experience in negotiation, mediation and arbitrations
• Experience in conducting technical claims audits and effectively following up on findings
• Ability to manage claims outside of local jurisdiction where appropriate, including understanding of laws and regulations
• Strong senior stakeholder management experience, both internal and external
• Ability to influence claims stakeholders and to effectively direct claims strategy
• Ability to lead within a team environment
• Strong presentation skills
• Excellent written and oral communication skills
• Strong analytical and problem solving skills
• Strong organization and time management skills
• Ability to deliver outstanding customer service
• Intermediate skills in Microsoft Office products (Excel, Outlook, Power Point, Word)
• Strong desire for continuous improvement

Responsibilities

• Confirms coverage of claims by reviewing policies and documents submitted in support of claims
• Analyzes coverage and communicates coverage positions
• Conducts, coordinates, and directs investigation into loss facts and extent of damages
• Directs and monitors assignments to experts and outside counsel
• Evaluates information on coverage, liability, and damages to determine the extent of insured's exposure
• Sets reserves within authority or makes claim recommendations concerning reserve changes to manager
• Negotiates and settles claims either directly or indirectly
• Prepares reports by collecting and summarizing information
• Adheres to Fair Claims Practices regulations
• Assists in training and mentoring of specialists, particularly in the excess and reinsurance business
• Serves as technical resource to subordinates and others in the organization
• Reviews and approves correspondence, reports and authority requests as directed by manager
• Participates in special projects or assists other team members as requested
• Travels to mediations, trials, and conferences as required
• Represents Markel’s claims expertise on external panels and industry forums
• Coordinates loss information for senior business stakeholders and presents during monthly/quarterly business meetings
• Contributes to maintenance of claims guidelines and best practice procedures
• Delivers technical training to colleagues and external contacts as appropriate
• Ensures effective vendor and litigation management on claims with a focus on minimizing indemnity exposure and mitigating vendor and legal expense
• Steps in for manager to assume managerial duties when manager is unavailable or requires assistance

Benefits

• Multiple health, dental and vision insurance plan options
• Optional life, disability, and AD&D insurance
• 401(k) with employer match contributions
• Employee Stock Purchase Plan
• PTO, corporate holidays and floating holidays
• Parental leave

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: Bachelor's degree
• Number of Employees: 5,001-10,000 employees