Senior Claims Specialist - Medical Professional Liability

ProAssurance
US - Texas - Texas City
December 26, 2024

An exciting opportunity exists to join the ProAssurance family of companies! Our mission is powerful and simple:
We protect others. Choosing a place to apply your talents is an important decision for anyone. You have plenty of options. Why choose ProAssurance?

At ProAssurance, we sell a pledge, and that pledge is delivered by our team members. We are seeking individuals who value integrity, leadership, relationships, and enthusiasm-and want to build their career with a great company where they can be their authentic self and feel valued, recognized, and rewarded for their contributions. ProAssurance specializes in healthcare professional liability, products liability for medical technology and life sciences, legal professional liability, and workers' compensation insurance. We are an industry-leading specialty insurer operating in all 50 states, with in-office, hybrid, and remote job opportunities around the country.

This position supports the misc medical (senior care, ambulatory, surgical center, hospice, pharmacy, etc) division of our medical professional liability line of business.

This role can be fully remote and located in the Mountain or Pacific Time Zones in order to meet the business of the position.

Candidates should have a minimum 5 years related experience and be located in one of the specified time zones for full consideration. Senior Care or Misc Med claims experience is highly desired.

Job Summary:

The primary responsibility of the Senior Claims Specialist position is to provide direction and guidance throughout the life of the complex claims, both litigated and non-litigated. The Senior Claims Specialist directs the management of complex claims including claims investigation, coverage analysis, monitoring of defense counsel activities, control of legal expenses, reserving, and providing technical expertise throughout the life of the claim file.

Essential Duties and Responsibilities:

25% - Investigates and evaluates liability, causation and damages in direct patient and litigated claims. Ensures proper file documentation of assigned files, by complying with company and state requirements. Establishes and continually evaluates case reserves.
25% - Responsible for preparing reports for management, by collecting, analyzing, and summarizing claim information. Keeps apprised of changes in the law and court procedures affecting claims in jurisdictions supervised.
25% - Collaborates with defense counsel with regard to defense tactics and strategies, per department guidelines. Maintains communication with Director and Counsel. Participates in selection of expert witnesses.
15% - Attends trials, settlement conferences, mediations, and insured meetings.
5% - Review and approval of reasonable legal expenses and fees associated with the claim file, and negotiation of adjustment of charges when appropriate.
3% - Participates in settlement negotiations.

Secondary Responsibilities:

2% - Perform special projects as directed by management.

Qualifications:

Bachelor's degree required.
Advanced degree or certification in the medical, legal or insurance field preferred.
Minimum five years' experience managing high exposure claims or at least seven years' experience in the legal or medical field, with a high degree of specialized and technical competence.
Professional liability experience preferred.
Strong background and demonstrated ability in dealing with significant coverage matters.
Extensive travel may be required.
Willingness and ability to be available beyond normal business hours.
Excellent interpersonal communications and negotiation skills.
Ability to make prompt, intelligent decisions based upon detailed analysis of complex issues
Strong analytical skills.
Proven leadership, communication, and writing skills, strong interpersonal, and relationship management expertise.
Excellent organizational skills and the ability to handle multiple tasks effectively.
Valid driver's license required.

• LI-Remote

We are committed to providing a dynamic and inclusive environment where everyone can do their best work and grow personally and professionally.

For that reason, we partner with The Predictive Index (PI) - an organization equally committed to improving the working lives of people, to help us hire the best talent by providing additional insight about one's work style.

The position you applied to requires completion of two assessments prior to being scheduled to interview with a hiring manager. Completion of the assessments is not required in order for your application to be reviewed and to speak with a Talent Acquisition team member. These assessments are Behavioral and Cognitive (internal candidates will only receive the Behavioral assessment), and each assessment takes less than 12 minutes to complete.

After submitting your application, you will receive two emails from The Predictive Index inviting you to complete each of these assessments (please check your SPAM or Junk email folder if you do not see these emails in your inbox).

Position Salary Range
$72,962.00 - $120,400.00The salary range displayed represents the entirety of the pay grade for this position. Most candidates will start in the bottom half of the range. Factors that may be used to determine your actual salary include your specific skills, how many years of experience you have, your location and comparison to other team members already in this role.

Build your career with us and enjoy access to a best-in-class benefits program.

Read the full job description and apply online on the recuiter's web-site

Senior Claims Specialist - Medical Professional Liability

Senior Claims Specialist - Medical Professional Liability

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