Medical Malpractice Complex Claims Specialist

TEKsystems; United States; Remoto; USD 83.000 - 110.000; Tempo pieno

Descrizione del lavoro

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.

Competenze

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

Mansioni

• 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.

Conoscenze

complex claims

medical malpractice

insurance claim

Formazione

Bachelor's degree or equivalent experience

CA Certification required

Professional designations preferred

Descrizione del lavoro

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.