Position Summary:
This Senior Claims Consultant independently manages complex medical professional liability claims across multiple jurisdictions, exercising sound judgement in investigation, exposure evaluation, reserving, litigation management, and resolution. The successful candidate takes ownership of an assigned caseload, develops and executes proactive claim strategies, critically evaluates defense counsel’s recommendations, and provides clear, well supported recommendations to management. This role combines technical expertise, disciplined follow-through, and responsive, high touch service to our Members.
Key Functions:
Responsibilities include but are not limited to the following:
- Independently manage complex medical professional liability claims from investigation through resolution, within delegated authority.
- Provide proactive personalized Member service through regular communications and meetings at key claim stages, including initial assessment, strategy development, depositions, expert reviews, mediations, and trials.
- Collaborate with internal departments, defense counsel, experts, and other insurers and respond promptly to broker inquiries, as necessary.
- Investigate claims through medical record review, expert consultation and evaluation of liability causation, damages, and venue.
- Develop and execute proactive claim strategies, identify priorities, and complete timely follow up.
- Direct defense counsel and critically evaluate litigation strategy, recommendations and progress, expenses, and progress.
- Establish and reassess reserves, documenting basis for exposure evaluations and changes.
- Develop settlement strategies, obtain necessary consent and authority, and negotiate resolutions.
- Identify and promptly escalate coverage concerns, significant exposure changes, settlement demands and critical deadlines.
- Maintain current concise file documentation explaining analysis, decisions, and next steps.
- Prepare clear reports and Claims Committee presentations with supported recommendations.
- Maintain responsive, collaborative relationships with Members, counsel, experts, other insurers, and co-defendants.
Requirements / Qualifications:
- Bachelor’s degree or equivalent experience.
- Multi-state adjuster’s licenses preferred or ability to procure as requested.
- Five plus years of professional medical liability including hospital professional liability claims experience with strong knowledge of claim evaluation, litigation management, coverage, reserving, negotiation, settlement strategy, and regulatory requirements.
- Demonstrated ability to independently assess complex claims, develop supported recommendations, manage competing priorities, and follow through on commitments.
- Excellent interpersonal, verbal, and written communication skills. Ability to present effectively to large or small groups.
- Ability to travel as determined by location, needs of member, and/or Court requirements, as necessary. Travel destinations include the company office for in-person events twice a year.
- Strong commitment to customer service, quality, and working in a collaborative team environment.
- Demonstrated technical ability to work with Microsoft Office, ShareFile, and Adobe Acrobat Pro.
The salary range for this position is $97,200 to $156,200. The range displayed on each job posting reflects the minimum and maximum for new hire salaries for the position. Starting salary is determined by several factors, including job-related skills, experience, and relevant education or training. This position is also eligible for an annual company bonus at an incentive target level of 10%.
We also offer a comprehensive benefits program, including a generous retirement program and Paid Time Off. Please visit Physicians Insurance - A Mutual Company for detailed benefit descriptions.
At Physicians Insurance, you’ll find an exceptional hybrid work environment, and the opportunity to work for an industry leader whose programs have a positive impact on insurance and healthcare.
OUR PURPOSE
To protect, defend, and support our Members
OUR VALUES
People-First - we treat everyone with respect and empathy
Expertise - we strive to be the best at what we do
Commitment - as a mutual company, we are accountable and dedicated to our Members and to each other
Bachelor's degree or equivalent experience; 5+ years medical professional liability claims experience; multi-state adjuster's licenses preferred; strong communication and technical skills; ability to travel to company office twice a year.
Key Responsibilities
- managing claims
- investigating claims
- negotiating settlements
Skills & Tools
Microsoft Office, ShareFile, Adobe Acrobat Pro
Job Details
- Category: Finance and Accounting
- Seniority: Senior Level
- Commitment: Full Time
- Workplace: Remote — Seattle or United States
- Salary: USD 97,200 – 156,200 / year
- Languages: English
Benefits
- Generous paid time off
- Retirement plan
About Physicians Insurance A Mutual Company
A mutual company providing insurance and claims services to protect, defend, and support its members. — Industry: Finance