Claim Consultant – Medical Professional Liability

🔥 17 hours ago

🇺🇸 United States – Remote

💵 $87.5k - $118.5k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

💼 Consultant

👻 Ghost score 0%

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Coverys

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2010

🏥 Healthcare

💼 Consulting

🛡️ Insurance

Healthcare • Consulting • Insurance

Coverys is a leading provider of insurance and risk management solutions, specializing in medical professional liability insurance for healthcare professionals and organizations. With over 45 years of experience, Coverys is rated A (Excellent) and is committed to protecting healthcare providers such as doctors, surgeons, nurses, and healthcare facilities including hospitals and outpatient centers. The company offers a wide range of insurance products designed to meet the specific needs of the healthcare sector, including risk mitigation services and value-based care risk protection. Coverys is also involved in the community through the Coverys Community Healthcare Foundation, which provides charitable contributions and grant programs to support healthcare and related organizations. Driven by a mission to support and protect the healthcare community, Coverys is dedicated to innovation and improving healthcare outcomes through its suite of services.

📋 Description

• Investigate, evaluate and dispose of MPL and General Liability claims with varying degrees of complexity and severity • Provide complete claim loss services for policyholders independently • Interview insureds, claimants, witnesses and other appropriate parties to assess liability exposure • Document investigation and negotiation results in related files • Prepare reports on established diary dates and other specific reports • Secure records for investigation and case evaluation • Determine and implement negotiation strategies and negotiate settlements within authority level • Adjust reserves and make reserve recommendations for amounts above authority • Advise Claim Director and/or S.V.P. of Claims on claim status and attend Reserve & Settlement Committee Meetings as necessary • Interact with other departments to facilitate and coordinate services for insureds and clients • Evaluate cases for disposition and seek settlement authority when required • Direct and monitor defense counsel activities in compliance with Case Management Guidelines • Monitor trials and attend pre-trial proceedings, mediations and arbitrations as necessary • Identify significant Risk Management or Underwriting issues and direct information to the appropriate department • Communicate with insureds, claimants and witnesses and consult medical and other relevant records • Analyze and verify insurance coverage • Maintain working knowledge of policy forms and confirm policy in effect for date of loss

🎯 Requirements

• Bachelor's degree from four-year college or university • R.N. or J.D. preferred • 3-5 years’ experience in clinical nursing and/or 3-5 years claims experience dealing with serious bodily injury • Knowledge of medical, legal and insurance terminology is required • Must hold a current driver's license • Strong written and oral communication skills • Must have training in contract/policy review and application • Must be comfortable making oral presentations to staff and insureds • Must be able to synthesize complex or diverse information; collect and research data; use intuition and experience to complement data; design workflows and procedures • Must have the ability to design and generate creative solutions • Insurance adjuster's license may be required for specific states • Ability to travel 25-30% required

🏖️ Benefits

• Ability to travel 25-30% required