HC
Clinical Account Consultant managing Medicare formulary strategy at HCSC. Collaborating with teams to develop and execute formulary strategies compliant with regulatory requirements.
About the role
- Claim Consultant managing construction-related general liability claims with a focus on superior customer service and investigative rigor. Accountable for complex claims involving litigation and high exposure.
Responsibilities
- Demonstrate the ability to timely manage medium to high exposure accounts exhibiting detailed claim knowledge with a well-reasoned analytical focus and a claim resolution strategy
- Provide proactive communications to customers and business partners in the management of claims
- Respond to inquiries from customers and provide superior customer service
- Review and analyze complex policies and coverage parts
- Write and articulate coverage positions
- Conduct investigations regarding claims and/or lawsuits
- Manage litigation and counsel, inclusive of litigation planning, budgeting, and implementing a liability resolution strategy
- Make liability and damages assessments
- Pursue coverage and liability risk transfer against other liable parties and insurance carriers
- Expertly contribute to loss cost management by recognizing potential for Subrogation and Special Investigation
- Attend mediations and trials, as necessary
- Manage expenses, reserves and financial transactions
Requirements
- Bachelor’s degree preferred
- 5+ years commercial general liability claim handling experience
- Western jurisdiction knowledge preferred
- Strong verbal and written communication skills
- Ability to present in a roundtable setting with a well-reasoned and analytical evaluation
- Strong analytical, problem solving and critical thinking skills
- Strong customer service and active listening skills
- Strong time management and organization skills
- Strong negotiation and conflict resolution skills
- Consistently utilize and maintain up to date metrics
- Working knowledge of MS Office especially Word and Excel
- Active Property & Casualty State Insurance Adjuster license, preferred
Benefits
- Other rewards may include short-term or annual bonuses
- long-term incentives
- on-the-spot recognition
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