Claim Counsel

Position Summary

Remote or Hybrid

Claims Counsel independently manages an assigned inventory of medical professional liability and related claims from initial notice through final resolution. Applying legal and claims judgment within delegated authority, this role analyzes coverage, liability, causation, damages, litigation strategy, reserves, and resolution opportunities while providing responsive service to insured healthcare professionals and organizations.

Claims Counsel serves as an internal legal and claims resource, directs defense counsel and other service providers, and works closely with Claims leadership, Underwriting, Risk Management, Finance, Claims Administration, and other business partners. The role requires proactive file ownership, practical legal analysis, accurate documentation, sound financial stewardship, and clear communication.

What You Will Do

· Manage an assigned inventory of claims and incidents from initial receipt through final disposition, taking timely action at each diary interval and maintaining complete, accurate, and contemporaneous electronic file documentation.

· Handle matters in accordance with applicable insurance policies, legal and regulatory requirements, company procedures, delegated authority, and current claims guidelines.

· Review notices of claims and incidents; analyze policy language and coverage; identify potential denials, reservations of rights, material coverage questions, conflicts, and other significant issues; and elevate matters requiring additional approval or specialized review.

· Evaluate liability, causation, damages, venue, defenses, co-defendant responsibility, potential exposure, and resolution strategy through factual, legal, medical, and financial analysis.

· Establish or recommend timely indemnity and expense reserves within delegated authority, document the supporting rationale, and update reserves when material information changes the expected ultimate loss or allocated expense.

· Conduct regular reviews of every assigned open file to assess reserve adequacy, investigation or litigation status, current strategy, and the actions needed before the next review.

· Select, retain, assign, and direct qualified investigators, defense counsel, consultants, and experts in accordance with company procedures; provide clear assignments and monitor strategy, performance, reporting, budgets, fees, and invoices.

· Review and analyze pleadings, discovery, medical records, expert opinions, investigation reports, evaluations, legal research, and litigation budgets; provide strategic direction and follow up on outstanding work.

· Prepare timely claim reports, legal and claim analyses, claim summaries, reserve and settlement recommendations, management reports, and other required documentation.

· Provide timely, candid, and appropriately detailed communications and notices to insureds, management, reinsurers, regulators, Finance, and other stakeholders while preserving privilege, confidentiality, and protected information as required.

· Serve as a primary claims and legal contact for insureds; explain claim status and strategy; assist with pre-suit matters, subpoenas, depositions, discovery, and early-intervention opportunities; and respond promptly and professionally to questions and concerns.

· Evaluate settlement opportunities, participate in negotiations, and resolve matters within delegated authority; prepare well-supported requests for additional reserve or settlement authority.

· Promptly escalate policy-limit, excess, time-sensitive, reputational, conflict-sensitive, or otherwise significant demands and issues in accordance with company procedures.

· Attend mediations, settlement conferences, significant depositions, hearings, and trials when appropriate, including travel or work outside normal business hours when claim needs require.

· Monitor indemnity and expense payments and confirm that authority, supporting documentation, releases, closing materials, reinsurance communications, and system entries are complete before a file is closed.

· Conduct periodic claim reviews with insureds and provide appropriate healthcare-law, medical-legal, claims, risk-management, and educational support, including presentations and training programs.

· Develop and maintain subject-matter expertise in an assigned legal, claims, or operational area, such as HIPAA and the handling of protected health information, and help maintain current guidance, processes, and training for that area.

· Participate in claim committee and departmental meetings; identify claim trends, legal developments, and emerging risks; collaborate with business partners; recommend process and service improvements; and support training and mentoring of less experienced claims personnel.

What You Bring

· Bachelor's degree and Juris Doctor degree from an accredited law school.

· Active license to practice law in Missouri, with ongoing good standing and compliance with applicable continuing legal education requirements.

· Relevant experience in medical professional liability, healthcare litigation, complex casualty claims, insurance coverage, or comparable claim management; direct medical malpractice experience is strongly preferred.

· Working knowledge of civil litigation, medical malpractice and general liability principles, claim investigation, coverage analysis, reserving, negotiation, litigation budgeting, and settlement evaluation.

· Ability to analyze complex legal, medical, factual, and financial information; exercise independent legal and claims judgment within delegated authority; and provide practical, business-oriented advice.

· Demonstrated ability to manage a substantial caseload, competing deadlines, and detailed documentation while maintaining timely follow-through.

· Clear, professional written and verbal communication with insureds, counsel, leaders, regulators, vendors, and other stakeholders.

· High standards of integrity, confidentiality, professionalism, organization, collaboration, customer service, and financial stewardship, with the ability and willingness to travel or occasionally work outside normal business hours.

Preferred Qualifications

· Experience managing medical malpractice or professional liability claims involving physicians, hospitals, or other healthcare organizations.

· Experience analyzing insurance coverage, drafting coverage communications, directing defense counsel, and evaluating significant or complex litigation.

· Familiarity with reinsurance reporting, healthcare privacy requirements, and regulated claim environments.

· Professional certifications such as RPLU, CPHRM, CPCU, AIC, or comparable credentials.

Work Environment

This is a full-time hybrid position based in Jefferson City, Missouri, subject to business needs and company policy. The role requires regular use of a computer and telephone, sustained attention to detailed information, and periodic travel for claim-related activities. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.

Additional Information

This description summarizes the general nature and level of work expected for the position. It is not an exhaustive list of responsibilities, duties, or qualifications, and responsibilities may change based on business needs. Employment is subject to applicable company policies and legal requirements.

We are an equal opportunity employer and consider qualified applicants without regard to race, color, religion, sex, pregnancy, national origin, age, disability, genetic information, veteran status, or any other status protected by applicable law.

Please email your resume to:

Leslie Jeffries, Director of Human Resources

ljeffries@hsg-group.com

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Parental leave
• Professional development assistance
• Retirement plan
• Tuition reimbursement
• Vision insurance

Work Location: Hybrid remote in Jefferson City, MO 65109