Medical Malpractice Claims Specialist

King's Insurance Staffing; United States; On-site; USD 90,000 - 130,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

Paid time off

Paid holidays

Retirement programs

Job summary

King's Insurance Staffing represents a well-established insurance carrier seeking an experienced Medical Malpractice Claims Specialist to independently manage a portfolio of medical malpractice and healthcare professional liability claims from initial notice through final resolution. The role is fully remote and requires strong claims expertise.

The ideal candidate will conduct thorough investigations, analyze coverage and liability, evaluate claim exposure, and collaborate with insureds,

Qualifications

• 5+ years of experience handling medical malpractice, healthcare professional liability, or comparable complex professional liability claims.

Responsibilities

• Independently manage medical malpractice and healthcare professional liability claims throughout the full claim lifecycle, from initial reporting through resolution.
• Manageable caseload ranging from 90-100 files.
• Analyze policy language, coverage provisions, and claim circumstances to identify coverage issues and determine claim applicability.
• Conduct comprehensive claim investigations, including reviewing medical records, legal documentation, expert reports, and other relevant materials.
• Communicate with insureds, claimants, attorneys, medical professionals, expert consultants, and other parties throughout the claim process.
• Evaluate liability, damages, venue, litigation exposure, and overall claim value while developing appropriate resolution strategies.
• Manage complex and litigated claims, including selecting, retaining, and partnering with defense counsel and medical experts.
• Negotiate settlements and pursue timely, cost-effective claim resolutions within assigned authority.
• Draft clear and professional claim correspondence, including coverage determinations, reservation of rights letters, and other coverage-related communications.
• Maintain accurate claim documentation, reserves, action plans, and file updates in accordance with internal standards and regulatory requirements.
• Proactively identify claim trends, emerging exposures, and opportunities to mitigate loss severity.

Skills

Medical malpractice claims

Litigation management

Coverage analysis

Investigation

Negotiation

Job description

Our client, a well-established insurance carrier specializing in professional liability coverage, is seeking an experienced Medical Malpractice Claims Specialist to join their team. This individual will independently manage a portfolio of medical malpractice and healthcare professional liability claims from initial notice through final resolution.

The ideal candidate will bring strong technical claims expertise, sound judgment, and experience handling complex and litigated medical malpractice matters. This role requires the ability to conduct thorough investigations, analyze coverage and liability, evaluate claim exposure, and work closely with insureds, defense counsel, medical experts, and other stakeholders to drive effective claim outcomes. Qualified candidates must have the ability to work fully remote!

Responsibilities

• Independently manage medical malpractice and healthcare professional liability claims throughout the full claim lifecycle, from initial reporting through resolution.
• Manageable caseload ranging from 90-100 files.
• Analyze policy language, coverage provisions, and claim circumstances to identify coverage issues and determine claim applicability.
• Conduct comprehensive claim investigations, including reviewing medical records, legal documentation, expert reports, and other relevant materials.
• Communicate with insureds, claimants, attorneys, medical professionals, expert consultants, and other parties throughout the claim process.
• Evaluate liability, damages, venue, litigation exposure, and overall claim value while developing appropriate resolution strategies.
• Manage complex and litigated claims, including selecting, retaining, and partnering with defense counsel and medical experts.
• Negotiate settlements and pursue timely, cost-effective claim resolutions within assigned authority.
• Draft clear and professional claim correspondence, including coverage determinations, reservation of rights letters, and other coverage-related communications.
• Maintain accurate claim documentation, reserves, action plans, and file updates in accordance with internal standards and regulatory requirements.
• Proactively identify claim trends, emerging exposures, and opportunities to mitigate loss severity.

Qualifications

• 5+ years of experience handling medical malpractice, healthcare professional liability, or comparable complex professional liability claims.
• Demonstrated experience managing complex and litigated claims from inception through resolution.
• Strong understanding of liability investigations, coverage analysis, policy interpretation, damages evaluation, and litigation management.
• Experience working directly with defense counsel, medical experts, insured healthcare professionals, and other external partners.
• Working knowledge of medical terminology and legal processes related to medical malpractice and professional liability claims.
• Strong negotiation, analytical, organizational, and decision-making skills.
• Excellent written and verbal communication skills, including the ability to prepare professional coverage and claim correspondence.
• Ability to independently manage multiple complex claims, prioritize competing deadlines, and maintain a high level of attention to detail.
• Professional insurance designations such as AIC, CPCU, SCLA, or similar credentials are a plus.
• Comprehensive medical, dental, and vision insurance
• Paid time off
• Paid holidays
• Additional benefits and retirement programs available