Complex Healthcare Claims Consultant - Medical Malpractice

CNA; Washington (District of Columbia); Hybrid; USD 72,000 - 141,000; Full time

Job summary

CNA seeks a Complex Claims Consultant to support Healthcare Claims, including Allied Healthcare Providers, Aging Services and Dental Malpractice. You will investigate, manage and resolve high-exposure claims across multiple states, interpreting policy language and coordinating with underwriting and defense counsel.

You will mentor others, maintain reserves, and pursue subrogation or fraud findings as applicable, while delivering timely, high-quality service to insureds and partners.

Qualifications

• Bachelor’s degree or equivalent experience.
• Typically minimum six years of relevant experience in claim handling or medical malpractice litigation.
• Must obtain/maintain Insurance Adjuster License within 90 days of hire.
• Prior negotiation experience; CPCU designation preferred.

Responsibilities

• Manage an inventory of highly complex commercial claims with large exposures.
• Verify policy coverage, conduct investigations and develop resolution strategies.
• Lead investigations to determine compensability, liability and damages.
• Negotiate complex settlements and manage litigation with counsel when needed.
• Maintain budgets, reserves and timely documentation of files.

Skills

Commercial insurance knowledge

Communication skills

Analytical mindset

Time management

Negotiation

Policy interpretation

Multi-tasking

Microsoft Office

Education

Bachelor’s Degree or equivalent experience

Insurance Adjuster License (within 90 days)

Professional designation CPCU preferred

Tools

Microsoft Office

Job description

CNA seeks a Complex Claims Consultant to support Healthcare Claims, including Allied Healthcare Providers, Aging Services and Dental Malpractice. You will investigate, manage and resolve high-exposure claims across multiple states, interpreting policy language and coordinating with underwriting and defense counsel.

You will mentor others, maintain reserves, and pursue subrogation or fraud findings as applicable, while delivering timely, high-quality service to insureds and partners.