Job SummaryThe Claims Division is seeking a highly experienced professional to join the Healthcare Claims Team as a Senior Claims Examiner. In this role, the examiner will be responsible for actively managing and effectively overseeing an assigned caseload of complex healthcare-related claims for hospitals, miscellaneous healthcare facilities and other healthcare providers.
Responsibilities - Identify and assess coverage issues, draft coverage position letters, and retain coverage counsel, when necessary as well as review coverage counsel's opinion letters and analysis
- Develop and implement strategy relative to coverage issues which correlate with the overall strategy of matters entrusted to the handler's care
- Develop and implement strategy to resolve matters of liability and damages of a particular case
- Maintain contact with the claim staff, business line leaders, underwriters, defense counsel, and brokers
- Investigate claim and review the insureds' materials, pleadings, and other relevant documents
- Identify and review of each jurisdiction's applicable statutes, rules, and case law
- Review litigation materials including depositions and expert's reports
- Analyze and direct risk transfer, additional insured issues, and contractual indemnity issues
- Retain counsel when necessary and direct counsel in accordance with resolution strategy
- Analyze coverage, liability and damages for purposes of assessing and recommending reserves
- Prepare and present written/oral reports to senior management setting forth all issues influencing evaluation and recommending reserves
- Travel to and from locations within the United States to attend mediations, trials, and other proceedings relevant to the resolution of the matter
- Negotiate resolution of claims
- Review and evaluate defense counsel invoices for reasonableness and process associated payments
- Maintain a diary of all claims, post reserves in a timely fashion, and expeditiously respond to claims inquiries from insured, counsel, underwriters, brokers, and senior management
Qualifications- Bachelor's degree required; Juris Doctorate degree preferred
- 3-7 years of work experience handling management liability claims process at a carrier, broker, or law firm
- Proper adjuster licensing in all applicable states preferred
- Exceptional communication (written and verbal), evaluation, influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines
- Strong time management and organizational skills
- Ability to take part in active strategic discussions
- Ability to work well independently and in a team environment
- Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word
- Willing and able to travel 15-20%
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For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible.
For NY, NJ: $123,400 - $191,628/year
For IL: $111,100 - $172,465/year
- Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future.
- Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits.
14400 Arch Insurance Group Inc.
