* Bachelor’s degree required.
* 5–10+ years of experience in insurance claims adjusting, preferably medical malpractice or professional liability.
* Strong knowledge of claims investigation, coverage analysis, and litigation management.
* Experience evaluating liability, damages, and settlement exposure.
* Ability to manage litigation files and direct defense counsel.
* Strong analytical, documentation, and decision-making skills.
* Experience conducting interviews and handling complex claim investigations.
* Ability to work independently in a remote or hybrid environment.
* Manage medical professional liability claims of moderate to high severity in accordance with company standards and industry best practices.
* Review and analyze policy coverage, including drafting reservation of rights letters and coverage denials.
* Investigate, evaluate, and adjust claims, retaining experts when necessary.
* Conduct witness interviews and perform on-site investigations as needed.
* Obtain, review, and analyze relevant documentation including medical records, bills, contracts, photos, and regulatory reports.
* Assess liability, damages, settlement value, verdict range, and probability of outcomes.
* Establish and maintain accurate indemnity and expense reserves.
* Coordinate and manage litigation, including oversight of defense counsel.
* Develop litigation strategy, action plans, and budgets.
* Review and process vendor invoices related to claims handling and litigation expenses.
Insurance Claims Examiner Adjuster Specialist Professional Liability Medical Malpractice MedMal Allied Healthcare _ .
REMOTE - WORK FROM HOME MAY BE AVAILABLE
Manage medical professional liability claims of moderate to high severity in compliance with company standards and industry best practices.
• Review and analyze policy coverage, including drafting coverage denials and reservation of rights letters.
• Investigate and evaluate claims, retaining experts when appropriate.
• Conduct witness interviews, including on-site visits.
• Identify, obtain, and analyze documentation including medical records, medical bills, contracts, photos, state health surveys, etc.
• Determine and evaluate liability, damages, settlement values, verdict ranges, and percent chance to win.
• Establish timely and accurate expense and indemnity reserves.
• Coordinate and manage litigation and defense counsel.
• Develop and implement litigation plan of action and budget.
• Review, analyze, and process vendor invoices.
Excellent compensation with bonuses. Full medical, dental, vision and prescription insurance plans as well as life insurance. Generous paid time off for vacation, holidays, personal and sick days. Tuition reimbursement for continued education provided.
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:
1000070592_10006796@najbcareers302.com
Please reference #42971VT421 when responding. Diedre Moire Corporation
Education Requirements: Bachelor Degree
Minimum Experience Requirements: 5-10 years
Job City Location: St Johnsbury
Job State Location: VT
Job Country Location: USA
Salary Range: $100,000 to $140,000
Diedre Moire Corporation, Inc.
diedremoire.com
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