Complex Claims Specialist

Primma, Llc; Village of Roslyn (NY); On-site; USD 130,000 - 150,000; Full time

Job summary

Primma, Llc is seeking a Complex Claims Specialist to handle complex medical liability claims in a professional, client-focused environment. The role is onsite with a hybrid option after training, located in Roslyn, NY or other stated offices, and requires strong analytical and negotiation abilities.

Qualifications include a Bachelor’s degree or JD, six years of claims handling experience (medical professional liability preferred) and NY adjuster licensure within 6–12 months.

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.

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.
• Actively manage defense counsel and partner on litigation strategy.
• Proactive communication with insureds, other departments and claim leadership.

Skills

Analytical skills

Problem-solving

Business writing

Communication

Mentorship

Confidentiality

Independent work

Education

Bachelor’s degree or JD

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Complex Claims Specialist

Full Time Professional Boston, MA, US

3 days ago Requisition ID: 1145

Salary Range: $130,000.00 To $150,000.00 Annually

**This role is onsite at our Roslyn, NY, Rochester, NY, or Hamilton, NJ 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.

• 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
• 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.