Demo

Medical Malpractice Claims Specialist

Scimaxconsulting
Orange, CA Full Time
POSTED ON 11/23/2025
AVAILABLE BEFORE 1/23/2026
Seeking a Claims Specialist for our Orange County office. This role involves handling technical and administrative responsibilities related to managing assigned claim files and taking on a larger caseload of highly complex claims.The Senior Claims Specialist also plays an active role in the ongoing training and oversight of Claims Specialist I and II team members.Responsibilities:Manage medical malpractice claims, including the assignment, direction, and control of defense counsel, under supervision and in compliance with the Claims Technical Manual, the Defense Attorney Guidelines, and the MPT Agreement. Manage increasingly complex cases with larger financial exposure.Investigate and evaluate claim files including complying with the standards of performance, interviewing members, reviewing medical records, corresponding with plaintiff attorneys, obtaining preliminary expert evaluation/opinions, and preparing interview summaries.Prepare case evaluation reports for publication and presentation to the CRC and CSC.Prepare case evaluation reports for discretionary authority on selected cases.Manage and participate in all litigation activity, including discovery plan, mediation, MSC, and negotiation under supervision, as necessary.Monitor arbitrations including daily progress reports to member and defense attorney with support.Prepare claim file resolution documentation.Timely update the claims database.Document all important case developments under the chronology tab.Code the claims file and update as relevant information is available. Timely review and index documents to the On Base system.Education and/or Experience: Bachelors degree from four-year college or university.Relevant legal and/or medical education background or the equivalent.5 years of medical malpractice claims management experience or 3 years claims experience

Salary.com Estimation for Medical Malpractice Claims Specialist in Orange, CA
$131,386 to $165,411
If your compensation planning software is too rigid to deploy winning incentive strategies, it’s time to find an adaptable solution. Compensation Planning
Enhance your organization's compensation strategy with salary data sets that HR and team managers can use to pay your staff right. Surveys & Data Sets

What is the career path for a Medical Malpractice Claims Specialist?

Sign up to receive alerts about other jobs on the Medical Malpractice Claims Specialist career path by checking the boxes next to the positions that interest you.
Income Estimation: 
$251,896 - $339,533
Income Estimation: 
$291,585 - $413,387
Income Estimation: 
$47,057 - $57,678
Income Estimation: 
$52,693 - $67,291
Income Estimation: 
$74,124 - $92,883
Income Estimation: 
$98,939 - $132,915
View Core, Job Family, and Industry Job Skills and Competency Data for more than 15,000 Job Titles Skills Library

Not the job you're looking for? Here are some other Medical Malpractice Claims Specialist jobs in the Orange, CA area that may be a better fit.

  • talentmovers inc Orange, CA
  • We are Hiring for Claims Specialist in Orange, CA Full Time Job DescriptionOur client is seeking a Claims Specialist for their Orange County office. This r... more
  • 1 Month Ago

  • United Career Network Orange, CA
  • Job Title – Medical Malpractice Claims SpecialistLocation – Orange, CA 92868Starting Salary – $110,000 – $130,000***NOTES****** Must have direct medical ma... more
  • 1 Month Ago

AI Assistant is available now!

Feel free to start your new journey!