Hybrid Healthcare Claims Specialist: Complex Claims

CNA Insurance; Plano (TX); Hybrid; USD 72,000 - 141,000; Full time

Job summary

CNA Insurance is seeking a Complex Claims Consultant to support varying healthcare provider segments in a hybrid role. You will investigate, manage, and resolve complex professional liability claims across multiple states with autonomy and partnership with Underwriting to inform good decisions.

The role requires a strong understanding of complex coverages, litigation coordination, and a commitment to high-quality service. A license within 90 days and a CPCU designation are preferred.

Qualifications

• Bachelor's Degree or equivalent experience.
• Typically six years of relevant experience in claims handling or medical malpractice litigation.
• Must have or be able to obtain Insurance Adjuster License within 90 days where applicable.
• Professional designations (e.g., CPCU) preferred.

Responsibilities

• Manages an inventory of highly complex commercial claims with large exposures.
• Ensures exceptional customer service and timely updates on claims.
• Verifies coverage and establishes reserves according to policy language.
• Leads investigations to determine compensability and liability.
• Negotiates complex settlements and manages litigation in coordination with counsel.
• Establishes and manages claim budgets and approves expenses.
• Identifies subrogation/salvage opportunities and potential fraud.

Skills

Commercial insurance

Negotiation

Litigation strategy

Analytical mindset

Communication skills

Policy interpretation

Multistate claims handling

Regulatory knowledge

Education

Bachelor's degree or equivalent experience

Insurance Adjuster license (preferred)

Tools

Microsoft Office

Claim management software

Job description

CNA Insurance is seeking a Complex Claims Consultant to support varying healthcare provider segments in a hybrid role. You will investigate, manage, and resolve complex professional liability claims across multiple states with autonomy and partnership with Underwriting to inform good decisions.

The role requires a strong understanding of complex coverages, litigation coordination, and a commitment to high-quality service. A license within 90 days and a CPCU designation are preferred.