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.
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