$110,000–$130,000 Per Year
Attorney, Case Management, Claims Management, Claims Processing, Conferences, Driver's License, Litigation, Medical Records, Negotiation Skills, Progress Reports, Technical Writing
Job Summary: Seeking a Senior Claims Specialist to manage a complex caseload of medical malpractice claims, supervise junior claims specialists, and contribute to ongoing training efforts.
Key Responsibilities:
- Manage medical malpractice claims , including assigning and directing defense counsel, following Claims Technical Manual, Defense Attorney Guidelines, and MPT Agreement.
- Handle increasingly complex claims with significant financial exposure.
- Investigate claim files by interviewing members, reviewing medical records, and corresponding with plaintiff attorneys.
- Obtain preliminary expert evaluations and prepare detailed interview summaries.
- Prepare case evaluation reports for review boards and discretionary authority.
- Manage litigation activities including discovery planning, mediation, mandatory settlement conferences, and negotiation under supervision.
- Monitor trials and arbitrations, provide daily progress reports, and support members and defense attorneys.
- Prepare claim resolution documentation and timely update claims databases.
- Document all case developments under chronology and update file coding with new information.
- Review and index documents into the OnBase system promptly.
- Assist management with special projects and training of Claims Specialist I and II team members.
- Identify, investigate, and follow up on coverage issues.
- Take and prepare Hotline calls as needed.
- Attend staff and department meetings as required.
- Perform other duties as assigned.
Education, Experience, Licenses and Certifications:
- Bachelor's degree from an accredited college or university.
- Relevant legal or medical education background or equivalent experience.
- Minimum 5 years' medical malpractice claims management experience or 3 years' CAP claims experience.
- Valid California driver's license required.
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Macpower Digital Assets Edge Private Limited