Complex Claims Consultant managing medical malpractice claims for Allied Healthcare Providers. Involves investigation, management, and resolution of claims in multi-state jurisdictions.
Responsibilities
Manages an inventory of highly complex commercial claims
Ensures exceptional customer service by managing all aspects of the claim
Verifies coverage and establishes timely and adequate reserves
Leads focused investigation to determine compensability, liability and covered damages
Resolves claims by collaborating with internal and external business partners
Establishes and manages claim budgets
Realizes and addresses subrogation/salvage opportunities or potential fraud occurrences
Achieves quality standards by appropriately managing each claim
Keeps senior leadership informed of significant risks and losses
Maintains subject matter expertise and ensures compliance with state/local regulatory requirements
Mentors, guides, develops and delivers training to less experienced Claim Professionals.
Requirements
Bachelor's Degree or equivalent experience
JD a plus
Typically a minimum six years of relevant experience, preferably in claim handling or medical malpractice litigation
Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable
Prior negotiation experience
Professional designations preferred (e.g. CPCU)
Benefits
CNA offers a comprehensive and competitive benefits package to help our employees – and their family members – achieve their physical, financial, emotional and social wellbeing goals.
Consultant for Business Continuity Management developing individual strategies and solutions for clients. Supporting with comprehensive Business Continuity Management systems in various industries.
Consultant for Business Continuity Management developing individual strategies and solutions for clients. Collaborating in building comprehensive Business Continuity Management systems in various industries.
Senior Consultant in IT Forensics supporting clients during cyber incidents and conducting forensic investigations. Collaborating on systems analysis and recovery efforts in a hybrid work environment.
Consultant in Energy and Smart Grid transformation projects at Wavestone. Focused on digital transformation, systems optimization, and client consulting in the energy sector.
(Senior) Consultant Azure Data Intelligence at Wavestone providing expertise on Microsoft Azure solutions. Responsible for client consulting, coaching new colleagues, and supporting a data driven community.
Consultant facilitating operational excellence and execution management for various client contexts. Engaging in projects to enhance operational performance and deliver value reliably.
ERP Consultant at Inway Systems implementing Dynamics 365 solutions for clients. Leading project teams, conducting workshops, and providing customer support post - implementation.
Entry Level Consultant at Oliver Wyman solving complex problems and driving meaningful change. Collaborating with colleagues globally in a diverse and inclusive environment.
Oracle Fusion SCM Sr Consultant providing functional support for Oracle Fusion Applications - SCM modules. Resolving incidents and coordinating with technical teams.
Senior Consultant managing ITGCs for SOX and Internal Audit at Armanino. Leading client engagements and mentoring junior staff while ensuring compliance and quality audit processes.