Claims Specialist, Healthcare

CFC; New York (NY); On-site; USD 120,000 - 160,000; Full time

Job summary

CFC is seeking an experienced Claims Specialist to join its Healthcare team in New York. You will handle US healthcare, professional indemnity and life sciences claims from first notification through settlement, ensuring compliance with policies, authorities and SLAs.

You’ll collaborate with Claims, Underwriting, Finance, IT and Products to support claims management and product development. You will build strong relationships with policyholders, brokers and capacity providers, manage deadlines

Qualifications

• Experience with professional liability and/or general liability claims.
• Interest in healthcare and life sciences.
• Organised, detail-focused and proactive with deadlines.

Responsibilities

• Handle US healthcare, professional indemnity and life sciences claims from first notification to settlement.
• Assess coverage, liability and quantum; ensure adherence to best practices and SLAs.
• Build relationships with policyholders, brokers, underwriters, capacity providers and vendors to deliver service.
• Prioritise claims activity and manage deadlines, letters and queries.
• Coordinate with external service providers for quality, value-for-money support within timeframes.
• Support process improvements, MI, administration and escalation of issues.
• Share claims insights with Underwriting and Products to assist product development and wording.
• Obtain and maintain US state claims adjuster licenses as required.

Skills

Claims handling

Relationship management

Communication skills

Detail-oriented

Job description

Claims Specialist, Healthcare

Department: Claims

Employment Type: Permanent - Full Time

Location: US - New York

Reporting To: Margaret Murphy

Compensation: $120,000 - $160,000 / year

Description

We’re looking for an experienced claims professional to join CFC’s Specialty Claims team, adjusting US healthcare and life sciences claims while helping deliver a high-quality service to policyholders, brokers and capacity providers.

You’ll handle claims from first notification through to settlement, build strong stakeholder relationships and work closely with teams across Claims, Underwriting, Finance, IT and Products to support effective claims management and product development.

About the role

• Work on US healthcare, professional indemnity and life sciences claims from first notification of loss to settlement, including coverage, liability and quantum analysis.
• Ensure claims are handled in line with CFC best practice, delegated authorities, binding authority SLAs, TCF and conduct risk requirements.
• Build strong relationships with policyholders, brokers, underwriters, capacity providers and vendors to deliver excellent service.
• Prioritise claims activity effectively, managing key legal deadlines, demand letters and claims queries.
• Work with external service providers to ensure quality, value-for-money support within agreed timeframes.
• Support claims process improvements, management information, administration and issue escalation.
• Share claims insight with Underwriting and Products to support product development and policy wording improvements.
• Obtain and maintain relevant US state claims adjuster licences, including any required examinations and Continuing Education hours.

About you

You’ll be an experienced claims professional with knowledge of professional liability and/or general liability claims, ideally with an interest in healthcare and life sciences.

Organised, detail-focused and proactive, you’ll be confident managing claims deadlines, legal documentation and stakeholder relationships while maintaining excellent customer service.

You’ll bring strong communication skills, sound judgement and a collaborative approach, with a willingness to obtain and maintain US state claims adjuster licences where required.

Core Values

Love what you do: We show up each day ready to take on the world. Our passion and intensity set us apart and makes the difference to our colleagues, customers, brokers and carriers.

Challenge everything: We’re never afraid to question the way that things are done and we constantly challenge ourselves and others to makes things better.

Have fun, be good: Insurance is a serious business, but we don’t take ourselves too seriously. We make it fun to work at CFC, we welcome all viewpoints, and we treat everyone how we would expect to be treated.