Complex Claims Specialist – Professional & General Liability

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⛰️ Colorado, Illinois, +3 more states – Remote

⛰️ Colorado – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote ❄️ Minnesota – Remote 🍑 Georgia – Remote

💵 $96k - $120k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

📋 Claims Specialist

🚫👨‍🎓 No degree required

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Pharmacists Mutual Insurance Company

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1909

💼 Consulting

🏥 Healthcare

⚖️ Legal

Consulting • Healthcare • Legal

Pharmacists Mutual Insurance Company is a mutual insurance provider, founded in 1909, that offers specialized insurance and risk-management solutions to independent community pharmacies and related healthcare professionals and businesses. It provides professional liability, property & casualty, and other tailored coverages for pharmacists, pharmacy technicians, pharmacy owners, dental and veterinary practices, home health and senior living facilities, emphasizing strong claims handling, loss control, and close relationships with agents and policyholders.

📋 Description

• Investigate, evaluate, reserve, negotiate and resolve assigned professional and general liability claims • Handle complex litigated and non-litigated liability cases with the highest level of exposure • Provide timely, professional claim handling and superior customer service • Conduct coverage analysis and communicate with insureds based on policy information and case facts or allegations • Investigate claims through contact with internal and external resources and experts • Interview witnesses and take statements as necessary • Use diary management systems to ensure timely claim handling and document protocol departures • Attend and present at roundtables and authority discussions • Resolve and close claims within delegated authority using creative or alternative resolution strategies • Negotiate claim disposition with insureds, claimants and legal representatives • Track and control legal and adjusting expenses • Attend mediations, arbitrations, pre-trials, trials and other legal proceedings as needed • Manage files through selection and direction of counsel under litigation guidelines • Evaluate recovery potential and assist with recovery efforts • Serve as a subject matter expert and provide coaching, file oversight and training resources • Assist the manager with quality-control audits

🎯 Requirements

• High School Diploma or equivalent and 10 years of related experience; or Associate’s Degree or equivalent and 8 years of related experience; and one of the listed industry-related certifications • Bachelor’s Degree and 5 years of related experience; or Master’s Degree with 2 years of related experience • One of the following industry-related certifications: AIC, AIC-M, AIM, CRM, SCLA, ARM or CPCU for the high-school/associate pathway • Licensing required in some states • Understanding of insurance claims principles and practices • Understanding of complex policy and contract coverage • Ability to manage, negotiate and resolve claims • Ability to work longer hours when workload fluctuations occur • Effective oral and written communication • Ability to analyze complex issues and make critical decisions • Excellent writing skills and professional English usage • Ability to interpret and apply laws, rules and regulations • Ability to manage and resolve multiple high-exposure claims simultaneously • Proficiency with claims management software and Microsoft Office • Ability to organize, prioritize work, work independently, meet deadlines and handle pressure • Experience in professional liability, general liability and various other lines • Advanced or specialized training/certifications preferred: AIC, AIC-M, AIM, CRM, SCLA, ARM, CPCU

🏖️ Benefits

• Annual discretionary bonus • Health, Dental, Vision & Life coverage • 401(k) with Company Match • Paid Time Off • 8 Paid Holidays • Volunteer Time Off • Paid Parental Leave • Hybrid/Remote Work Options • Employee Assistance Program • Tuition Reimbursement

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