Senior Claims Specialist

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Senior Claims Specialist
Duties: Manage medical malpractice claims across multiple jurisdictions with some relevant experience handling nursing home facility or long-term care claims. Analyze and address coverage issues timely and accurately under multiple policy contracts. Use knowledge of claim investigations, litigation, insurance contracts and industry contracts. Promptly and properly develop the facts of a claim through a comprehensive investigation, accurate documentation, and prompt contact with all knowledgeable parties. Maintain well documented and articulate file notes able to be read and understood by not only the claim team, but also agents and customers. Evaluate complex damages, liability exposures. Set accurate and timely reserves. Advanced skills managing complex file; including mass torts. Direct control of the litigation management process and expenses. Proactively manage a claim inventory and effectively negotiate cases to an acceptable resolution under moderate supervision. Present cases and regularly share expertise through the claim committee process. Encourage others to develop their technical skills through everyday interactions within the business unit and in support of strong team results. Recognize potential fraud and third party contribution issues and handle as appropriate. Adhere to all statutory regulations and Unfair Claim Practices Acts.

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