Medical Malpractice Complex Claims Consultant

We are seeking a fully remote Medical Malpractice Complex Claims Associate:

Description1)
Manages an inventory of highly complex professional liability claims, with large exposures that require a high degree of specialized technical expertise and coordination, by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits;2) Ensures exceptional customer service by managing all aspects of the claim, interacting professionally and effectively, achieving quality and cycle time standards, providing timely updates and responding promptly to inquiries and requests for information;3) Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters, estimating potential claim valuation, and following company's claim handling protocols;4)
Leads focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim;5)
Resolves claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that includes management of timely and adequate reserves, collaborating with coverage experts, negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority;6)
Establishes and manages claim budgets by achieving timely claim resolution, selecting and actively overseeing appropriate resources, authorizing expense payments and delivering high quality service in an efficient manner;7)
Realizes and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Claim, Recovery or SIU resources for further investigation;8)
Achieves quality standards by appropriately managing each claim to ensure that all company protocols are followed, work is accurate and timely, all files are properly documented and claims are resolved and paid timely;9)
Keeps senior leadership informed of significant risks and losses by completing loss summaries, identifying claims to include on oversight/watch lists, and preparing and presenting succinct summaries to senior management;10)
Maintains subject matter expertise and ensures compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business
11) May perform additional duties as assigned.

Skillscomplex claims, medical malpractice, insurance claim

Top Skills Detailscomplex claims,medical malpractice,insurance claim

Additional

Skills & Qualifications Education & Experience Bachelor's degree or equivalent experience. Professional designations preferred.

Typically a minimum three to five years claims  Certifcation required

Skills, Knowledge & Abilities Solid knowledge of claims and insurance industry theory and practices.
2. Demonstrated technical expertise and product specific knowledge.
3. Strong interpersonal, communication and negotiation skills. Ability to effectively interact with all levels of CNA's internal and external business partners.
4. Ability to work independently, managing time and resources to accomplish multiple tasks and meet deadlines.
5. Strong analytical and problem solving skills enabling viable alternative solutions.
6. Ability to exercise independent judgement and make critical business decisions effectively assessing the merits of claims as well as evaluating claims based on a cost benefit analysis.
7. Solid knowledge of Microsoft Office Suite as well as other business-related software.
8. Ability to adapt to change and value diverse opinions and ideas.
9. Ability to fully comprehend claim information; and to further articulate analyses of claims in internal reports. 10. Ability to handle claims with a proactive long-term view of business goals and objectives.

Job Type & Location This is a Contract position based out of Chicago, IL.Pay and Benefits The pay range for this position is $60.00 - $80.00/hr individual compensation offered for this position within this range will depend on many factors, including qualifications,…