Medical Professional Liability Claims Representative

Responsibilities:

• Investigate, evaluates, and negotiates or otherwise resolves claims assigned with Texas and/or other states.
• Analyzes coverage and drafts appropriate correspondence to policyholders.
• Ensures proper evaluation and reserving of assigned claims.
• Develops claim files on assigned cases, documenting all transactions related to file handling.
• Reports progress and results in a timely manner and in accordance with claim department directives.
• Negotiates directly with claimants and/or their legal representatives and is responsible for prompt and proper disposition of all claims within delegated authority.
• Selects and assigns defense counsel; works closely with defense counsel to control their use of discovery proceedings and to ensure effective defense of suits.
• Manages expenses including reasonableness of attorneys' fees.
• Seeks standard of care opinions from outside consultants. Suggests additions and/or deletions to consult list.
• Attends and monitors trials.
• Coordinates and participates in Litigation Management reviews for selected defense firms.
• Completes state board of insurance reporting form (if required) and national data bank reporting form (if required), upon closing a claim.
• Attends defense meetings with attorneys and policyholders when appropriate.
• Attends and participates in mediations including the direction of negotiations, if any.

Desired Skills

• Strong analytical skills.
• Effective oral and written communication skills.
• Knowledge and understanding of basic professional liability insurance contracts, regulations, and litigation.
• Five years of progressively responsible experience in the casualty insurance field handling bodily injury claims (physicians' liability experience preferred).
• Bachelor's degree and Adjuster's License required. Incumbent meeting other selection criteria except possession of Adjuster's License will be required to obtain license within six months of employment.

Other

This is an Austin based hybrid model position and requires the availability for some travel including overnight stays. Any offer of employment is conditioned upon satisfactory completion of a background and driving record verification.

Job Type: Full-time

Pay: $70,000.00 - $164,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible schedule
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Professional development assistance
• Referral program
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Work setting:

• Hybrid work
• Office

Work Location: Hybrid remote in Austin, TX 78746