Sr. Medical Claims Adjuster

CHG Healthcare • Midvale, UT

35d

About The Position

Healthcare’s helping hand. CHG shook things up in 1979 by inventing the locum tenens staffing model. We connect doctors with patients who need their care. As the largest physician staffing firm in America, our providers treat millions of patients each year. Our industry is growing and demand is high. This means you’ll have plenty of opportunities to grow and develop in your career. Keeping healthcare healthy can be as fun as it is rewarding The Sr. Medical Claims Adjuster is responsible for managing medical professional liability claims; managing data concerning medical professional liability claims within a database; interacting with medical providers; managing external counsel; traveling (when necessary) to attend mediations, depositions, and trials; and negotiating and settling medical professional liability claims and lawsuits within established settlement authority. This role will report to Medical Claims Manager.

Requirements

• Familiarity with claims management systems (preferably Assure Claims).
• Working knowledge of Microsoft Excel (pivot tables, lookups, indexes, etc.).
• Sound understanding of claim reserving process and loss runs.
• Strong interpersonal and communication skills with demonstrated ability to build trust and credibility with team members, providers, counsel, and leadership.
• Proven ability to provide constructive feedback and coaching in a professional, supportive manner that promotes growth and accountability.
• Leadership presence and sound judgment in managing sensitive personnel matters and maintaining confidentiality.
• Ability to develop and maintain productive working relationships based on mutual respect, transparency, and ethical conduct.
• 5+ years of medical professional liability management experience.
• Multi-state experience adjusting medical professional liability claims.
• Willingness and ability to travel (nationally).
• Demonstrated track record of building high-performing teams through establishing trust, maintaining professional standards, and developing talent.
• Experience managing difficult conversations, providing corrective feedback, and addressing performance issues in a constructive and professional manner.

Nice To Haves

• Bachelor’s Degree or Nursing Degree with an emphasis in insurance, claims, or healthcare risk management.
• 2-3 years managing direct reports with specific responsibilities around hiring, performance management, and coaching
• Licensed insurance adjuster.

Responsibilities

• Document disciplinary actions, incidents, claims, and lawsuits concerning medical professional liability.
• Determine whether a covered claim has been made under the terms and conditions of a relevant policy of insurance and maintain a working knowledge of insurance policy forms to verify coverage.
• Establish, monitor, and authorize changes to indemnity and expense reserves on assigned claim files.
• Assign claim files to and supervise outside defense counsel, adjusters, and investigators and/or monitor medical professional liability claims being handled by an insurance company under an insured program.
• Evaluate liability and exposure in assigned claim files.
• Establish and proactively manage appropriate claim resolution, including formation and implementation of resolution strategy.
• Identify responsive documents and witnesses to properly evaluate incidents, claims, and lawsuits.
• Participate in periodic claim reviews with leadership.
• Independently manage incidents, claims, and lawsuits, including attending mediations and trials as necessary.
• Provide updates and recommendations on strategy for resolving incidents, claims and lawsuits to Sr. Leadership.
• Maintaining professional standards, conducting difficult conversations constructively, and modeling ethical conduct.
• Experience in building trust through transparency, ethical decision-making, and consistent leadership
• Mentoring team development and fostering a positive culture.
• Ability to provide feedback, leadership presence, and relationship-building capabilities.

Benefits

• 401(k) retirement plan with company match
• Traditional healthcare benefits such as medical and dental coverage, and some unique benefits like onsite health centers, corporate wellness programs, and free behavioral health appointments.
• Flexible work schedules - including work-from-home options available
• Recognition programs with rewards including trips, cash, and paid time off
• Family-friendly benefits including paid parental leave, fertility coverage, adoption assistance, and marriage counseling
• Tailored training resources including free LinkedIn learning courses
• Volunteer time off and employee-driven matching grants
• Tuition reimbursement programs

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 1,001-5,000 employees