Claims Examiner

Claims Examiner - Medical Professional Liability
Locations: Roslyn, NY | Rochester, NY | Hamilton, NJ (Onsite with hybrid flexibility post-training)

A leading insurance organization is seeking a skilled Claims Examiner with expertise in medical professional liability to join their team.

Overview:

In this role, you'll manage complex, high-exposure claims from start to finish, applying your knowledge to ensure fair and efficient resolution. You'll play a key role in maintaining client satisfaction while adhering to best practices in claims handling.

Key Responsibilities:

• Conduct thorough investigations and assess coverage, liability, and damages
• Maintain organized and well-documented claim files, identifying areas for process improvement
• Collaborate with underwriting and client service teams to support account relationships
• Set and adjust reserves based on exposure and claim developments
• Develop and execute resolution strategies, including negotiation and settlement
• Attend mediations, trials, and other legal proceedings as needed
• Provide mentorship and technical guidance to junior team members
• Oversee defense counsel and contribute to litigation strategy
• Ensure consistent communication with insureds, internal teams, and leadership
• Uphold data accuracy and compliance with internal protocols

Qualifications:

• Bachelor's degree or Juris Doctor required
• Minimum of 5 years of experience in claims handling, preferably in medical professional liability
• Ability to obtain a New York adjuster's license within 6-12 months of hire
• Strong analytical and decision-making skills
• Excellent written and verbal communication abilities
• Demonstrated ability to work independently and collaboratively
• High ethical standards and discretion with sensitive information
• Willingness to travel as needed, including occasional overnight trips
• Must be available to work onsite

This is a great opportunity for a claims professional looking to take on complex files in a supportive and high-performing environment.