Complex Claims SpecialistPrimma, LLC • Roslyn, NY, US

Complex Claims Specialist

Primma, LLC • Roslyn, NY, US

30+ days ago

Job type

Full-time

Job description

Job Description

This role is onsite at our Roslyn, NY or Rochester, NY office, with the option for a hybrid schedule after the training period.

General Summary : A Complex Claims Specialist will possess experience in handling complex medical liability claims, while demonstrating a strong client service focus.

Essential Duties & Responsibilities :

Follow standard claims protocols for documentation, coverage verification, and file management

Maintain accurate and organized claims files, suggesting improvements as necessary.

Manage significant client relationships for claims department, collaborate with underwriting on marketing.

Investigate and document most significant exposures, setting appropriate indemnity and expense reserves

Develop resolutions strategy and lead negotiations and bring matters to a close

Attend trials and mediations when necessary

Adhere to industry Best Practices for effective claim management

Mentor staff through formal and informal training and development; demonstrate extensive technical expertise to guide and support less experienced claims professionals

Ensure exceptional data integrity

Actively manage defense council and partner on litigation strategy

Proactive communication with insureds, other departments and claim leadership

Perform additional duties and responsibilities as assigned

Education & Qualifications :

Bachelor’s degree or JD required

Six years’ claims handling experience required; medical professional liability strongly preferred

NY adjusters license required within the first 6 - 12 months of employment

Strong analytical and problem-solving skills with attention to detail

Demonstrate solid and concise business writing proficiency

Exhibit strong oral communication skills to include presenting information clearly and effectively to diverse audiences

Ability to work independently as well as assume a mentorship role within a team. Act as a strong example and resource for less experienced colleagues

Strong ethical judgement and a commitment to maintaining confidentiality

Must be able to work on site

Travel required as needed; may include overnight travel

The actual compensation for this position will be determined by experience and other factors permitted by law.

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Claim Specialist • Roslyn, NY, US

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