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Complex Claims Specialist

Primma, LLC
locationRoslyn, NY, USA
PublishedPublished: 6/14/2022
Full Time

Job Description

Job Description

**This role is onsite at our Roslyn, NY or Rochester, NY office, with the option for a hybrid schedule after the training period. **

General Summary: A Complex Claims Specialist will possess experience in handling complex medical liability claims, while demonstrating a strong client service focus.

Essential Duties & Responsibilities:

  • Follow standard claims protocols for documentation, coverage verification, and file management
  • Maintain accurate and organized claims files, suggesting improvements as necessary.
  • Manage significant client relationships for claims department, collaborate with underwriting on marketing.
  • Investigate and document most significant exposures, setting appropriate indemnity and expense reserves
  • Develop resolutions strategy and lead negotiations and bring matters to a close
  • Attend trials and mediations when necessary
  • Adhere to industry Best Practices for effective claim management
  • Mentor staff through formal and informal training and development; demonstrate extensive technical expertise to guide and support less experienced claims professionals
  • Ensure exceptional data integrity
  • Actively manage defense council and partner on litigation strategy
  • Proactive communication with insureds, other departments and claim leadership
  • Perform additional duties and responsibilities as assigned

Education & Qualifications:

  • Bachelor’s degree or JD required
  • Six years’ claims handling experience required; medical professional liability strongly preferred
  • NY adjusters license required within the first 6 - 12 months of employment
  • Strong analytical and problem-solving skills with attention to detail
  • Demonstrate solid and concise business writing proficiency
  • Exhibit strong oral communication skills to include presenting information clearly and effectively to diverse audiences
  • Ability to work independently as well as assume a mentorship role within a team. Act as a strong example and resource for less experienced colleagues
  • Strong ethical judgement and a commitment to maintaining confidentiality
  • Must be able to work on site
  • Travel required as needed; may include overnight travel

The actual compensation for this position will be determined by experience and other factors permitted by law.





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