• Casualty Medical Malpractice Claims examiner

    Job Location(s) US-CA-San Diego
    Job ID
    2018-1602
    # of Openings
    1
    Category
    Casualty - Medical Malpractice
    Job Type
    Regular Full-Time
  • Overview

    Position Summary:

    Responsible for the detailed and efficient examination, investigation and resolution of high exposure, complex medical malpractice/ casualty claims and lawsuits through effective investigation, negotiation and interaction with the involved parties.

    Responsibilities

    Job Functions

    • Review, process and conclude assigned claims including high exposure, complex Medical Malpractice and other assigned casualty claims.
    • Complete timely and effective review of coverage, recognizing and timely addressing potential coverage issues.
    • Oversee and direct a majority of litigated or potentially litigated claims, directing and working with the client, counsel and investigative services toward timely resolution.
    • Maintain an ongoing diary.
    • Continually assess exposure and evaluate for accurate reserves.
    • Prepare Loss Reports providing a thorough analysis of liability and damages.
    • Maintain appropriate financial accountabilities (reserving) and control loss adjustment expenses in accordance with Best Practices and Client claim handling instructions.
    • Document all correspondence, reports, discussions and decisions.
    • Provide quality service to all customers.

    Qualifications

     

      • 10 + years casualty claims experience, with at least 5 years medical malpractice claims experience
      • Advanced knowledge of medical malpractice/ casualty handling concepts, practices and techniques.
      • Must be highly organized and detail oriented.
      • Ability to work effectively with defense counsel to bring about timely and reasonable resolution of litigated cases.
      • Demonstrated advanced verbal and written communications skills.
      • Demonstrated advanced analytical, decision making and negotiation skills.
      • Computer proficiency.
      • Writing sample required.
      • (see below for additional preferred skills)
    • Ability to communicate effectively and clearly, both orally and in writing.
    • Ability to manage relationships in a fast paced environment, while demonstrating problem solving and decision making skills to work with customers.
    • Good analytical abilities to review, exercise judgment and evaluate claims and coverage in order to make sound decisions with a minimal amount of supervision.
    • Excellent negotiation skills.
    • A thorough understanding of the litigation process.
    • Ability to carry out detailed written or verbal instructions, ability to respond to requests effectively and efficiently and exhibit good common sense.
    • An ability to handle assigned claims following client guidelines and best practices with a minimal amount of supervision.
    • Time management skills, organizational skills and ability to prioritize issues and tasks.
    • Ability to effectively operate computer equipment and applications.
    • Independence, flexibility and creativity.

     

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