Complex Loss Specialist (Allied Health)
Our client is a rapidly growing, technology-driven MGA and insurance wholesaler that is transforming the specialty insurance market through innovation, data, and advanced technology. Led by a forward-thinking leadership team, the organization is focused on delivering best-in-class specialty insurance solutions to brokers and agents nationwide. With continued growth across its claims division, our client is looking to add a Complex Loss Specialist (Allied Health) to their team.
This individual will be responsible for managing the organization's most complex and high-exposure Allied Health, medical malpractice, and professional liability claims. The position offers the opportunity to handle sophisticated healthcare liability matters, collaborate with key stakeholders, and play a critical role in driving claim outcomes and litigation strategy.
Responsibilities within the role include:
- Analyze, investigate, evaluate, and manage complex Allied Health, medical malpractice, and professional liability claims from inception through resolution.
- Review coverage, assess liability and damages, analyze medical records, and determine claim exposure on high-severity losses.
- Partner closely with insureds, brokers, defense counsel, experts, underwriters, and other stakeholders throughout the claims process.
- Direct litigation strategy, retain and manage defense counsel, and oversee claim-related activities to achieve favorable outcomes.
- Establish and maintain appropriate reserves, evaluate settlement opportunities, and provide recommendations on high-exposure claims.
- Prepare comprehensive claim reports, maintain accurate file documentation, and communicate claim developments to management.
- Conduct detailed investigations through the collection and analysis of medical records, contracts, witness statements, and other supporting documentation.
- Present complex claims to senior leadership and participate in strategy discussions regarding claim resolution, litigation management, and exposure mitigation.
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