• Bachelor's degree or equivalent
• 5-10 years of professional liability, medical malpractice, or healthcare claims experience
• Experience handling complex, high-exposure, and severe injury medical malpractice claims
• Strong knowledge of claim investigation, liability analysis, litigation management, and settlement negotiation
• Experience working with defense attorneys, mediators, and legal counsel
• Knowledge of reserve analysis, claim valuation, and exposure assessment
• Experience identifying subrogation, recovery, fraud, and cost-containment opportunities
• Strong analytical, negotiation, and decision-making skills
• Excellent written and verbal communication skills
• Ability to manage multiple complex claims while maintaining high levels of customer service
• Manage highly complex and severe injury medical malpractice claims from investigation through resolution
• Analyze and investigate medical malpractice claims to determine liability, damages, and exposure
• Identify and pursue opportunities for fraud detection, subrogation, contribution, recovery, and case management to reduce overall claim costs
• Establish, calculate, and maintain appropriate claim reserves throughout the life of each claim
• Coordinate legal defense activities, including assignment of defense counsel and oversight of litigation strategy
• Review attorney invoices and monitor counsel compliance with company and client guidelines
• Represent the company during depositions, mediations, settlement conferences, and trial monitoring activities
• Develop and recommend settlement strategies, including structured settlements when appropriate
• Negotiate claim settlements within assigned authority levels
• Communicate claim status, strategy, and developments to clients and internal stakeholders
• Ensure claim files are properly documented, maintained, and coded in accordance with company standards
• Monitor claim activity to ensure timely and effective claim resolution
Insurance Claims Examiner Adjuster Specialist Professional Liability Medical Malpractice MedMal Allied Healthcare _ .
REMOTE - WORK FROM HOME MAY BE AVAILABLE
Manage total claim costs for highly complex or severe injury medical malpractice claims while negotiating to resolution and providing high levels of customer service.
• Analyze and investigate complex or technically difficult medical malpractice claims to determine exposure.
• Identify and investigate for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost.
• Calculate and assign timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life.
• Coordinate legal defense by assigning attorney, reviewing attorney invoices, and monitoring counsel for compliance with client guidelines.
• Represent Company in depositions, mediations, and trial monitoring.
• Recommend settlement strategies, including structured settlement proposals as necessary to maximize settlement.
• Negotiate claim settlement up to designated authority level.
• Communicate claim activity and processing with clients.
• Ensure claim files are properly documented and claims coding is correct.
In addition to a killer compensation plan, the company believes in recognizing hard work, dedication, and success with perquisites including bonus packages, non-monetary incentives, plenty of paid time off, and more! Company is highly rated by employees for job satisfaction, work-life balance, compensation, management structure, and career oriented environment.
For complete details contact Greg Foss at:
(609) 584-9000 ext 270
Or submit resume online at:
http://dmc9.com/gbf/app.asp
Or email to:
1000070891_10006796@najbcareers302.com
Please reference #42971NY588 when responding. Diedre Moire Corporation
Education Requirements: Bachelor Degree
Minimum Experience Requirements: 5-10 years
Job City Location: Irondequoit
Job State Location: NY
Job Country Location: USA
Salary Range: $100,000 to $140,000
Diedre Moire Corporation, Inc.
diedremoire.com
WE ARE AN EQUAL OPPORTUNITY EMPLOYER and our employment decisions are made without regard to race, color, religion, age, sex, national origin, handicap, disability or marital status. We reasonably accommodate individuals with handicaps, disabilities and bona fide religious beliefs. Jobs Career Position Hiring. CONSIDERED EXPERIENCE INCLUDES: Insurance Claims Examiner Adjuster Specialist Professional Liability Medical Malpractice MedMal Allied Healthcare #DiedreMoire #JobSearch #JobHunt #JobOpening #Hiring #Job #Jobs #Careers #Employment #jobposting #InsuranceJobs #UnderwriterJobs
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