What are the responsibilities and job description for the Senior Claims Examiner, Healthcare position at Arch Mortgage Insurance?
Senior Claims Examiner, Healthcare
remote type
Hybrid Working
locations
New York, NY United States of America
Morristown, NJ United States of America
Jersey City, NJ United States of America
Chicago, IL United States of America
Philadelphia, PA United States of America
Garden City, NY United States of America
time type
Full time
posted on
Posted Today
job requisition id
R26_670
With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠.
Position Summary
The Claims Division is seeking a highly experienced professional to join the Healthcare Claims Team as a Senior Claims Examiner. In this role, the examiner will be responsible for actively managing and effectively overseeing an assigned caseload of complex healthcare-related claims for hospitals, miscellaneous healthcare facilities and other healthcare providers.
Responsibilities
Identify and assess coverage issues, draft coverage position letters, and retain coverage counsel, when necessary as well as review coverage counsel's opinion letters and analysis
Develop and implement strategy relative to coverage issues which correlate with the overall strategy of matters entrusted to the handler's care
Develop and implement strategy to resolve matters of liability and damages of a particular case
Maintain contact with the claim staff, business line leaders, underwriters, defense counsel, and brokers
Investigate claim and review the insureds' materials, pleadings, and other relevant documents
Identify and review of each jurisdiction's applicable statutes, rules, and case law
Review litigation materials including depositions and expert's reports
Analyze and direct risk transfer, additional insured issues, and contractual indemnity issues
Retain counsel when necessary and direct counsel in accordance with resolution strategy
Analyze coverage, liability and damages for purposes of assessing and recommending reserves
Prepare and present written/oral reports to senior management setting forth all issues influencing evaluation and recommending reserves
Travel to and from locations within the United States to attend mediations, trials, and other proceedings relevant to the resolution of the matter
Negotiate resolution of claims
Review and evaluate defense counsel invoices for reasonableness and process associated payments
Maintain a diary of all claims, post reserves in a timely fashion, and expeditiously respond to claims inquiries from insured, counsel, underwriters, brokers, and senior management
Experience & Required Skills
5-7 years of work experience handling management liability claims process at a carrier, broker, or law firm
Exceptional communication (written and verbal), evaluation, influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines
Strong time management and organizational skills
Ability to take part in active strategic discussions
Ability to work well independently and in a team environment
Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word
Willing and able to travel 15-20%
Education
Bachelor’s degree required; Juris Doctorate degree preferred
Proper adjuster licensing in all applicable states preferred
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For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible.
For NY, NJ: $123,400 - $191,628/year
For IL: $111,100 - $172,465/year
Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future.
Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits.
Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn’t the right fit but you’re interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch’s Talent Acquisition team.
14400 Arch Insurance Group Inc.
Salary : $123,400 - $191,628