Lead Complex Medical Claims Specialist (Hybrid)

Primma,-LL; Boston (MA); On-site; USD 130,000 - 150,000; Full time

Job summary

Primma, LLC in Boston, MA is seeking a Complex Claims Specialist with extensive medical professional liability experience. This full-time, on-site role requires handling complex claims, client service focus, and collaboration with underwriting.

You will follow standard claims protocols, manage relationships, mentor staff, supervise defense counsel, and coordinate negotiations. Travel may be required; on-site requirement applies; NY, NJ offices are listed for hybrid options after training.

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.
• Must be able to work on site.
• Travel required as needed; may include overnight travel.

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.
• Perform additional duties and responsibilities as assigned.

Skills

Analytical skills

Problem solving

Oral communication

Written communication

Mentorship

Ethical judgement

Independent worker

Education

Bachelor's degree or JD

Six years’ claims handling experience

NY adjusters license

Job description

Primma, LLC in Boston, MA is seeking a Complex Claims Specialist with extensive medical professional liability experience. This full-time, on-site role requires handling complex claims, client service focus, and collaboration with underwriting.

You will follow standard claims protocols, manage relationships, mentor staff, supervise defense counsel, and coordinate negotiations. Travel may be required; on-site requirement applies; NY, NJ offices are listed for hybrid options after training.