Claims Examiner

markelcorp; Chicago (IL); On-site; USD 64,000 - 107,000; Full time

Benefits offered by this job

Health insurance

401(k) with employer match

Paid time off & holidays

Parental leave

Job summary

Markel Group in Chicago seeks a Claims Examiner to resolve average complexity and low to mid exposure healthcare claims nationwide. The role involves investigation, evaluation, negotiation, and settlement in accordance with policy provisions and contract terms.

The successful candidate will analyze coverage, manage litigation with defense counsel, work with underwriting, and maintain clear reporting. Strong communication and collaboration skills are essential, as is the ability to handle a

Qualifications

• Excellent written and oral communication skills.
• Ability to analyze and convey summations of complex issues both verbally and in writing.
• Experience in determining contractual obligations, insurance coverage analyses, and investigations.
• Ability to manage litigation, set loss and expense reserves and evaluate settlement values.

Responsibilities

• Investigate, negotiate and settle primary and excess policy healthcare claims.
• Investigate and analyze coverage under healthcare policies; draft coverage correspondence; communicate positions to stakeholders.
• Manage nationwide litigation; direct defense counsel; assist with vendor management and disbursement tasks.
• Communicate with underwriting on significant developments and alert Claims Manager to adverse issues.
• Contribute to initiatives and action plans with the Claims Manager.
• Participate in agent related functions and meetings as required.

Skills

Communication skills

Analytical ability

Team collaboration

High-volume case load management

Travel readiness

Education

College degree

Professional designation

Job description

What part will you play?

If you're looking for a place where you can make a meaningful difference, you've found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you'll find your fit amongst our global community of optimists and problem-solvers. We're always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs.

Join us and play your part in something special!

This position will be responsible for the resolution of claims of average complexity and low to mid exposure claims. The primary purpose of this job is to investigate, evaluate, negotiate, and settle assigned claims by collecting and analyzing data according to policy application and/or contract provisions.

Responsibilities:

• Investigate, negotiate and settle primary and excess policy healthcare claims.
• Investigate and analyze coverage under primary and excess healthcare professional liability insurance policies; make coverage determinations; draft coverage correspondence; effectively communicate coverage positions to policyholders and other stakeholders.
• Manage litigation filed nationwide against insureds; appoint, direct and manage defense counsel; proactively work toward expeditious and economical resolution of claims; assist Company claims vendor management, disbursement and legal collections teams with defense counsel, bill payment and collection issues.
• Communicate with underwriting as needed to manage claims and to alert of any significant developments.
• Promptly communicate with Claims Manager on adverse case developments and provide information on pertinent issues affecting the healthcare professional liability product line.
• Proven ability to work in a collaborative team environment. Analyze and convey summations of claim issues; recognize alternative approaches and develop action plans, both orally and in written form.
• Maintain and adhere to Markel's guidelines and procedures.
• Ensure proper adherence to internal reporting requirements.
• Contribute and assist in the implementation of a wide range of initiatives, discussion and action plans brought forth by the Claims Manager.
• Participate in agent related functions and meetings as required.

Requirements:

• College degree, professional designation and/or related job experience required.
• Excellent written and oral communication skills.
• Ability to analyze and convey summations of complex issues both verbally and in writing; recognize alternative approaches and develop action plans
• Experience in determining contractual obligations, insurance coverage analyses, and investigations.
• Ability to manage litigation, set loss and expense reserves and evaluate settlement values.
• Work collaboratively and as a team player willing to assist within the Unit and Professional Liability Division as needed.
• Ability to proactively self-manage a high volume caseload.
• Travel required as necessary (approximately 10%).

US Work Authorization

US Work Authorization required. Markel does not provide visa sponsorship for this position, now or in the future.

Pay information:

The base salary offered for the successful candidate will be based on compensable factors such as job-relevant education, job-relevant experience, training, licensure, demonstrated competencies, geographic location, and other factors. The national average salary range for the Claims Examiner is $64,400 - $107,300 with a 12% incentive.

Who we are:

Markel Group (NYSE - MKL) a fortune 500 company with over 60 offices in 20+ countries, is a holding company for insurance, reinsurance, specialist advisory and investment operations around the world.

We're all about people | We win together | We strive for better

We enjoy the everyday | We think further

What's in it for you:

In keeping with the values of the Markel Style, we strive to support our employees in living their lives to the fullest at home and at work.

We offer competitive benefit programs that help meet our diverse and changing environment as well as support our employees' needs at all stages of life.

• All full-time employees have the option to select from multiple health, dental and vision insurance plan options and optional life, disability, and AD&D insurance.
• We also offer a 401(k) with employer match contributions, an Employee Stock Purchase Plan, PTO, corporate holidays and floating holidays, parental leave.

Are you ready to play your part?