Claim analyst Empleos en Houston tx

Overview

Salary: Salary could go up to $165,000 per year, dependent upon experience Jurisdictions: Open to any Licenses: must be willing to obtain all licenses stated by manager within specified timeframe Location: This role is eligible for fully remote work. The Senior Claims Specialist within GB Specialty is responsible for managing moderately complex Healthcare Professional Liability claims, with a primary focus on Physician Medical Malpractice exposures. This role manages the full claim life cycle, including coverage analysis, investigation, evaluation, and resolution, while ensuring claims are handled in accordance with client expectations, policy obligations, and regulatory requirements. How you'll make an impact Analyzes coverage and settles moderately complex claims in Healthcare Professional Liability focusing on Physician Claims (Medical Malpractice). Generally, incumbent does not work on workers’ compensation claims. Able to manage the full-life cycle of all assigned claims files. Analyzes coverage and determines defense obligations. Under minimal supervision, conducts thorough analysis and investigations necessary to determine claims exposure and recommend appropriate settlement strategies and action plans. Creates reservation of rights and coverage denial letters. Negotiates settlements with clients, client attorneys, and Public Adjusters. Interacts extensively with various parties involved in the claims process, and may recommend retaining the advice of outside experts as necessary. Prepares reserve and settlement authority requests for client and carrier approval. May act as a client advocate with carriers to ensure proper claims handling, including any necessary scoping, estimating, and addressing of coverage. Has a solid understanding of claims processing and the insurance brokerage business. Has a basic understanding of the terminology and case law associated with healthcare professional liability claims. Handles claims consistent with clients’ and corporate policies, procedures and best practices and in accordance with statutory, regulatory, and ethical requirements. Incumbents at this level should be able to work at full caseload capacity. About You Required: Bachelor's Degree and 5+ years related claims experience required. Prior experience working within the applicable specialty claims area or demonstrated ability to handle unique/challenging claims issues. Appropriately licensed and/or certified in all states in which claims are being handled or able to obtain the licenses/certification per local requirements. Knowledge of accepted industry standards and practices. Computer experience with related claims and business software. Preferred: JD Highly Preferred Licensed Attorney highly preferred. 2+ years of prior experience adjusting claims in Healthcare professional Liability Behaviors: Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges. Analytical skill necessary to make decisions and resolve issues inherent in handling of claims. Ability to successfully negotiate the settlement and disposition of claims including the ability to interpret related documentation. #LI-TJ1 #GBSpecialtyCareers Compensation and benefits We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits. Below are the minimum core benefits you’ll get, depending on your job level these benefits may improve: Medical/dental/vision plans, which start from day one! Life and accident insurance 401(K) and Roth options Tax-advantaged accounts (HSA, FSA) Educational expense reimbursement Paid parental leave Other benefits include: Digital mental health services (Talkspace) Flexible work hours (availability varies by office and job function) Training programs Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing Charitable matching gift program And more... **The benefits summary above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process.