Senior Claim Specialist - Medical Malpractice

The Senior Medical Malpractice Claim Specialist is responsible for the independent investigation, evaluation, management, negotiation, and resolution of complex and high-severity medical malpractice and healthcare professional liability claims.

The position will manage a diverse portfolio of litigated and non-litigated matters involving hospitals and health systems, long-term care and senior living organizations, physician and medical groups, and allied healthcare professionals and facilities.

This role requires significant medical malpractice claims expertise, strong technical judgment, and the ability to develop and execute effective claim and litigation strategies. The Senior Medical Malpractice Claim Specialist will work closely with clients, insureds, defense counsel, medical experts, brokers, carriers, and other stakeholders to achieve high-quality claim outcomes while delivering exceptional client service.

• Bachelor's degree or equivalent combination of education and relevant professional experience.
• Juris Doctor (JD), Registered Nurse (RN), or other relevant legal or clinical background combined with significant claims experience preferred.
• Minimum of 7 years of progressively responsible medical malpractice, healthcare professional liability, or complex liability claims experience, with demonstrated responsibility for managing claims from initial notice through resolution.
• 10+ years of medical malpractice or healthcare professional liability claims experience preferred.
• Significant experience handling complex, litigated, and moderate-to-high-severity medical malpractice or healthcare professional liability claims.
• Demonstrated experience directing defense counsel, developing litigation strategy, evaluating liability and damages, establishing reserves, and negotiating complex settlements.
• Experience handling claims involving one or more of the following preferred:
• Hospitals and health systems
• Long-term care, skilled nursing, assisted living, and senior living organizations
• Physician and medical groups
• Allied healthcare professionals and facilities
• Experience managing high-severity claims involving catastrophic injury, wrongful death, significant permanent impairment, or substantial economic damages preferred.
• Experience working within a carrier, TPA, self-insured healthcare organization, captive, risk retention group, or other alternative-risk structure preferred.
• Strong knowledge of medical malpractice and healthcare professional liability claims, including standard-of-care, causation, damages, and medical-record analysis.
• Strong understanding of insurance coverage, policy interpretation, reserving principles, litigation management, and claim resolution strategies.
• Demonstrated ability to independently analyze complex medical, legal, and factual issues and make well-supported claim decisions.
• Excellent written and verbal communication skills, including the ability to prepare concise and persuasive claim evaluations, large-loss reports, reserve recommendations, and settlement authority requests.
• Strong negotiation, analytical, organizational, and client relationship skills.
• Ability to manage multiple complex matters and competing priorities while maintaining high standards for quality, responsiveness, and documentation.
• Must possess or be able to obtain and maintain required insurance adjuster licenses.
• Professional insurance designation such as CPCU, AIC, ARM, or equivalent preferred.

• Complex Claims Management
  • Independently manage a portfolio of complex and high-severity medical malpractice and healthcare professional liability claims from initial notice through final resolution.
  • Handle claims involving hospitals and health systems, long-term care and senior living facilities, physician and medical groups, allied healthcare providers, and other healthcare organizations and professionals.
  • Conduct comprehensive claim investigations, including review and analysis of medical records, incident reports, facility documentation, policies and procedures, witness information, pleadings, discovery, depositions, expert reports, and other relevant materials.
  • Evaluate liability, damages, causation, standard of care, venue, jurisdictional considerations, and other factors affecting claim exposure.
  • Identify significant severity drivers, emerging exposures, potential excess or reinsurance implications, and other issues requiring escalation or enhanced oversight.
  • Develop, document, and execute proactive claim strategies designed to achieve timely,…