What are the responsibilities and job description for the Technical Claims Specialist - Medical position at TDC Brand?
TDC Specialty Underwriters, Inc. (TDCSU), an Excess & Surplus lines subsidiary of The Doctors Company (the nation’s largest writer of physicians’ malpractice insurance based in Napa, California), offers a broad range of professional and management liability insurance products focused on healthcare providers, institutions and organizations. TDCSU has been in existence since January 2016 and is seeking to hire experienced professionals to support its continued growth. TDCSU is headquartered in Farmington, Connecticut.
TDCSU is currently seeking a Technical Claims Specialist to handle complex medical professional liability claims.
Responsibilities:
Working under the general supervision of the Vice President and acting within authority appropriate for this position, the senior claims handler is expected to:
The primary responsibilities of this position are to investigate, evaluate and resolve complex medical claims. The position requires handling claims across varied medical specialties and across the country.
Conducts investigations to gather evidence and facts sufficient to make appropriate decisions including obtaining review of medical records and expert opinions.
Reviews coverage and seeks consultation on coverage issues; evaluate liability and damages; determines appropriate course of action for case resolution. Makes decisions and takes action within authority.
Obtains written consent from insureds; negotiates settlements; utilizes appropriate methods, such as mediation, ADR, and structured settlements.
Evaluates reserves per company guidelines
Secures satisfactory results and timely closures
Works closely with defense counsel to establish litigation plan of actions and budgets
Presents claims at internal claim roundtables
Attending mediations, court conference and trials
Knowledge of most recent verdicts across the country and tracking trends
Conduct excess audits
TDCSU is also seeking candidates with a desire to contribute to a collaborative, motivated and professionally ambitious work environment.
Preferred Candidates:
Should possess strong knowledge of relevant legal decisions, claim trends and industry practices
Requirements:
6 – 10 years medical malpractice
Proficiency with Excel, Word and demonstrated aptitude with Windows based operating systems
Adjustor’s license