Claims Specialist, Healthcare

CFC

$120K — $160K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • 5-7 years of experience in claims management, particularly in healthcare or life sciences
  • Strong understanding of professional and general liability claims
  • Proven ability to manage multiple claims and meet deadlines
  • Excellent communication skills for stakeholder engagement
  • Proficiency in claims analysis, from liability to settlement
  • Detail-oriented with strong organizational skills
  • Willingness to obtain necessary US state claims adjuster licenses

Responsibilities

  • Handle claims from first notification to settlement, focusing on coverage and liability analysis
  • Ensure compliance with best practices and regulatory requirements during claims handling
  • Develop and maintain strong relationships with key stakeholders to enhance service delivery
  • Prioritize claims-related activities and manage legal deadlines efficiently
  • Collaborate with external service providers to ensure high-quality support within timeframes
  • Drive claims process enhancements and management reporting
  • Share insights with underwriting and product teams for continuous improvement

Benefits

  • Comprehensive healthcare coverage including dental and vision
  • 401(k) plan with company match
  • Generous paid time off policy including vacations and holidays
  • Professional development opportunities including training and certifications
  • Flexible working arrangements to promote work-life balance
Full Job Description
Claims Specialist, Healthcare

Department: Claims

Employment Type: Permanent - Full Time

Location: US - New York

Reporting To: Margaret Murphy

Compensation: $120,000 - $160,000 / year

Description

We're looking for an experienced claims professional to join CFC's Specialty Claims team, adjusting US healthcare and life sciences claims while helping deliver a high-quality service to policyholders, brokers and capacity providers.

You'll handle claims from first notification through to settlement, build strong stakeholder relationships and work closely with teams across Claims, Underwriting, Finance, IT and Products to support effective claims management and product development.

About the role
  • Work on US healthcare, professional indemnity and life sciences claims from first notification of loss to settlement, including coverage, liability and quantum analysis.
  • Ensure claims are handled in line with CFC best practice, delegated authorities, binding authority SLAs, TCF and conduct risk requirements.
  • Build strong relationships with policyholders, brokers, underwriters, capacity providers and vendors to deliver excellent service.
  • Prioritise claims activity effectively, managing key legal deadlines, demand letters and claims queries.
  • Work with external service providers to ensure quality, value-for-money support within agreed timeframes.
  • Support claims process improvements, management information, administration and issue escalation.
  • Share claims insight with Underwriting and Products to support product development and policy wording improvements.
  • Obtain and maintain relevant US state claims adjuster licences, including any required examinations and Continuing Education hours.


About you

You'll be an experienced claims professional with knowledge of professional liability and/or general liability claims, ideally with an interest in healthcare and life sciences.
Organised, detail-focused and proactive, you'll be confident managing claims deadlines, legal documentation and stakeholder relationships while maintaining excellent customer service.
You'll bring strong communication skills, sound judgement and a collaborative approach, with a willingness to obtain and maintain US state claims adjuster licences where required.

Similar Jobs

More Jobs at CFC

More Healthcare Jobs

Find similar Claims Specialist, Healthcare jobs: