Remote Medical Malpractice & General Liability Claims Expert

Acrisure; California; Remote; USD 95,000 - 125,000; Full time

Benefits offered by this job

Medical Insurance

401(k) Plan

Paid Time Off

Dental Insurance

Job summary

Acrisure is seeking an experienced claims professional to review, investigate and handle general commercial, professional and auto liability claims. You will manage high exposure claims, coordinate with attorneys, brokers and clients, and ensure timely, economic settlements.

This role supports the nationwide healthcare liability and professional liability claims portfolio. Requirements include a multi-state adjuster license, strong analytical and negotiation skills, and the ability to work

Qualifications

• High school diploma or equivalent required.
• Active multi-state adjuster license required.
• Experience handling professional liability/medical malpractice claims preferred.
• Strong analytical and negotiation skills.
• Proficient in MS Office and claims management software."],
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Responsibilities

• Receives claim assignments from claim supervisor; examines claim forms and other records to determine insurance coverage.
• Interviews, telephones, and/or correspond with claimant(s) and client within established time frame, document results.
• Consults police reports and medical records to determine nature and extent of the accident.
• Reviews medical bills to ensure treatment is reasonable, necessary and related to the injury.
• Ensures that claim file documentation and reserves are current; and keeps client advised on claim status.
• Negotiates settlement with claimant within limits of authority.
• Coordinates and monitors litigation with attorneys.
• Brings claims to conclusion.
• Handles caseload consisting of complex liability.
• Independently prepares for and attends client meetings to discuss claim status, reserve levels and action plans.
• Participates in mentoring programs to assist in the professional development of less experienced adjusters.
• Mentors less experience co-workers to develop their understanding of procedures, state laws, and help others improve their claims handling ability
• Assists with client development, education, and problem solving.
• Completes Excess reports and requests for reimbursement; submits these to carriers; follows up for recovery.
• Handles claims involving subrogation from investigation through recovery.
• On-site investigation of claims when necessary.
• Analyzes and resolves client issues independently.
• Manage healthcare liability claims involving healthcare facilities, and providers, under both primary and excess insurance policies across all 50 states.
• Ensure comprehensive oversight of complex claims, including investigation, evaluation, and resolution, while maintaining compliance with state-specific regulations and industry standards.
• Investigation plans for each claim; evaluating each with respect to standard of care, liability, causation and damages.
• Analyze and process complex or technically difficult medical malpractice lawsuits by investigating and gathering information, determining the exposure on the claim. Overall investigation and management of medical malpractice claims.
• Other duties may be assigned

Skills

Medical malpractice knowledge

Claims handling

Negotiation

Communication skills

Analytical thinking

Education

High School Diploma or equivalent

Active multi-state adjuster license

Tools

Microsoft Word

Excel

PowerPoint

Job description

Acrisure is seeking an experienced claims professional to review, investigate and handle general commercial, professional and auto liability claims. You will manage high exposure claims, coordinate with attorneys, brokers and clients, and ensure timely, economic settlements.

This role supports the nationwide healthcare liability and professional liability claims portfolio. Requirements include a multi-state adjuster license, strong analytical and negotiation skills, and the ability to work