Medical Malpractice Complex Claims Consultant

TEKsystems; United States; Remote; USD 83,000 - 110,000; Full time

Job summary

TEKsystems is seeking a fully remote Medical Malpractice Complex Claims Associate to manage highly complex professional liability claims with large exposures. Responsibilities include verifying coverage, conducting investigations, developing resolution strategies, and authorizing payments within authority limits.

The role requires 3–5 years of claims experience, a Bachelor's degree or equivalent, and CA Certification.

Qualifications

• Bachelor's degree or equivalent experience in a related field.
• CA Certification required for this role.
• Typically 3–5 years of claims experience.

Responsibilities

• Manages an inventory of complex professional liability claims with high exposures.
• Verifies coverage, investigates, and develops resolution strategies within authority limits.
• Manages all aspects of the claim and provides timely updates to stakeholders.
• Verifies coverage and reserves by reviewing policy language and engaging counsel as needed.
• Leads investigations to determine compensability, liability, and damages with relevant documents.
• Collaborates with partners to execute a claim resolution strategy and authorize payments.
• Manages claim budgets and resources to ensure timely resolution and high service quality.
• Addresses subrogation, salvage, or fraud opportunities and refers for further investigation.
• Maintains quality standards and proper documentation; ensures timely payment.
• Keeps leadership informed with loss summaries and risk highlights for oversight.
• Stays current on regulatory requirements and company guidelines; performs additional duties as needed.

Skills

complex claims

medical malpractice

insurance claim

Education

Bachelor's degree or equivalent experience

CA Certification required

Professional designations preferred

Job description

We are seeking a fully remote Medical Malpractice Complex Claims Associate:

Description

• 1) Manages an inventory of highly complex professional liability claims, with large exposures that require a high degree of specialized technical expertise and coordination, by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits;
• 2) Ensures exceptional customer service by managing all aspects of the claim, interacting professionally and effectively, achieving quality and cycle time standards, providing timely updates and responding promptly to inquiries and requests for information;
• 3) Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters, estimating potential claim valuation, and following company's claim handling protocols;
• 4) Leads focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim;
• 5) Resolves claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that includes management of timely and adequate reserves, collaborating with coverage experts, negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority;
• 6) Establishes and manages claim budgets by achieving timely claim resolution, selecting and actively overseeing appropriate resources, authorizing expense payments and delivering high quality service in an efficient manner;
• 7) Realizes and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Claim, Recovery or SIU resources for further investigation;
• 8) Achieves quality standards by appropriately managing each claim to ensure that all company protocols are followed, work is accurate and timely, all files are properly documented and claims are resolved and paid timely;
• 9) Keeps senior leadership informed of significant risks and losses by completing loss summaries, identifying claims to include on oversight/watch lists, and preparing and presenting succinct summaries to senior management;
• 10) Maintains subject matter expertise and ensures compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business
• 11) May perform additional duties as assigned.

Skills

complex claims, medical malpractice, insurance claim

Top Skills Details

complex claims,medical malpractice,insurance claim

Additional Skills & Qualifications

Education & Experience

Bachelor's degree or equivalent experience. Professional designations preferred.

Typically a minimum three to five years claims experience.

CA Certifcation required

Skills, Knowledge & Abilities

• Solid knowledge of claims and insurance industry theory and practices.
• 2. Demonstrated technical expertise and product specific knowledge.
• 3. Strong interpersonal, communication and negotiation skills. Ability to effectively interact with all levels of CNA's internal and external business partners.
• 4. Ability to work independently, managing time and resources to accomplish multiple tasks and meet deadlines.
• 5. Strong analytical and problem solving skills enabling viable alternative solutions.
• 6. Ability to exercise independent judgement and make critical business decisions effectively assessing the merits of claims as well as evaluating claims based on a cost benefit analysis.
• 7. Solid knowledge of Microsoft Office Suite as well as other business-related software.
• 8. Ability to adapt to change and value diverse opinions and ideas.
• 9. Ability to fully comprehend claim information; and to further articulate analyses of claims in internal reports.
• 10. Ability to handle claims with a proactive long-term view of business goals and objectives.

Job Type & Location

This is a Contract position based out of Chicago, IL.

Pay and Benefits

The pay range for this position is $60.00 - $80.00/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

Eligibility requirements apply to some benefits and may depend on your jobclassification and length of employment. Benefits are subject to change and may besubject to specific elections, plan, or program terms. If eligible, the benefitsavailable for this temporary role may include the following:Medical, dental & visionCritical Illness, Accident, and Hospital401(k) Retirement Plan Pre-tax and Roth post-tax contributions availableLife Insurance (Voluntary Life & AD&D for the employee and dependents)Short and long-term disabilityHealth Spending Account (HSA)Transportation benefitsEmployee Assistance ProgramTime Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a hybrid position in Chicago,IL.

Application Deadline

This position is anticipated to close on Oct 16, 2026.

About TEKsystems

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

About TEKsystems and TEKsystems Global Services

Were a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. Were a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. Were strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. Were building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

San Francisco Fair Chance Ordinance:

We may consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector:

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI):

We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team.