VP, Claims

Berkley•Chesterfield, MO

About The Position

Do you want to be part of a dynamic and growing organization that encourages creativity, collaboration, innovation and individual expression? Are you an insurance professional who wants to think “outside the box” in creating products, underwriting and servicing customers? Berkley Healthcare is a dynamic company that encourages a pioneering mindset with the financial backing of a Fortune 500 company. At BHFL, everyone’s voice counts and we expect to hear from everyone. If you want to work in a unique insurance company like no other, come explore career options with us. As a member company of W. R. Berkley Corporation, Berkley Healthcare has assembled a unique team of multi-disciplinary insurance professionals to take a fresh look at healthcare organization insurance. We pride ourselves on our deep expertise in underwriting, claims and distribution in the healthcare industry insurance market. We understand that the healthcare industry is in a state of rapid evolution; shaped by emerging concepts in technology, law, public welfare and social economics, all with attendant enterprise risk unique to healthcare organizations. We apply cutting-edge insurance concepts to traditional healthcare insurance products. Concepts that embrace the current complexity of the healthcare industry. Concepts that give ultimate flexibility in managing enterprise risk. Founded in 1967, W. R. Berkley Corporation is an insurance holding company that is among the largest commercial lines writers in the United States and operates worldwide in two segments of the property casualty insurance business: Insurance and Reinsurance. Each of the Berkley companies, or operating units within Berkley, participates in a niche market requiring specialized knowledge about a territory or product. Berkley Healthcare Medical Professional, a division of Berkley Healthcare, is seeking a highly accomplished, customer service-oriented claim professional to deliver superior claim results through execution of defined best practices while managing an inventory of high exposure and complexity healthcare professional liability claims

Requirements

Bachelor’s degree from four-year college or university; J.D. strongly preferred.
15 years of related experience handling healthcare professional liability claims.
Advanced knowledge of medical and legal terminology and concepts.
In-depth understanding of industry best practices for adjudicating casualty claims.
Proficiency with insurance contract interpretation and coverage issues.
Proficiency with Microsoft Office applications.
Willingness to travel up to 30% of the time.
Occasional evening and weekend work is required.

Nice To Haves

Experience servicing large healthcare accounts is strongly preferred.
Experience managing casualty claims in an excess environment is desirable.

Responsibilities

Investigate assigned claims through application of defined best practices. Actively develop information on reported claims, including specific facts of case, nature and extent of injury, standard of care and causation defenses, venue specific factors and other characteristics that impact claim severity.
Evaluate information obtained through claim investigations and estimate damage ranges for purposes of prompt identification of claims with potential excess exposure; apply ongoing triage rules to determine proper severity and assignment levels.
Directly manage and actively intervene on the most technically complex and highest severity claims within company inventory.
Timely recognize and evaluate claim exposures to establish accurate case reserves.
Execute effective claim adjudication strategies/tactics to help achieve optimal outcomes on exposures within and in excess of account retentions.
Cultivate strong business relationships with key personnel within current accounts, brokerage community, TPAs, and law firms within assigned territory.
Take lead claims role for on-site review process and support all account management needs of the company.
Aid in the development and modification of claim management practices, policies and procedures in furtherance of continuous process improvement culture.
Assist Underwriting and Actuarial in risk selection and pricing accuracy through claim due diligence for new and renewal business.
Utilize customer service skills with client contacts to advance business opportunities: Identify service needs for claim, risk management and data mining strategy; Understand renewal strategy; Extend discussion with client beyond claim transaction and toward potential needs not immediately recognized by the decision maker. Communicate effectively with team members.
Develop, or assist with development, of claims marketing content and utilization of content for marketing purposes.