REMOTE POSITION / CLAIMS PROCESSOR

California Dental Association; Crystal Bay (NV); Remote; USD 60,000 - 80,000; Full time

Benefits offered by this job

PTO + holidays

Medical/dental/vision

Professional development

Disability insurance

EAP

Remote/hybrid flexibility

Job summary

The Dentist Insurance Company (TDIC) is hiring a Claims Representative II, Professional Liability in a remote-first role with occasional travel and in-office meetings. You will investigate liability claims, coordinate with adjusters and attorneys, and determine appropriate reserves under supervision.

Requirements include a high school diploma or GED, 3+ years of liability claims experience, and proficiency in MS Windows Office; Associate or Bachelor’s degree preferred. Travel is possible.

Qualifications

• Requires a minimum of three years insurance experience in liability claims or similar position.
• Requires intensive communication with involved parties via phone.
• Must be able to perform job duties under supervision.
• Experience with claims management and estimating software preferred.

Responsibilities

• Investigate and determine cause and origin of loss and liability.
• Collaborate with outside adjusters, legal counsel and vendors to adjust claims.
• Negotiate claim resolutions under supervisor guidance.
• Maintain assigned caseloads with a diary system and timely communications.
• Review new claims with supervisor to determine course of action.
• Attend mandatory meetings and seek educational opportunities.

Skills

Communication skills

Education

High school diploma or GED

Associate’s or Bachelor’s degree preferred

Tools

MS Windows Office

AS400

Job description

Job Title: Claims Representative II, Professional Liability

Location: Remote first work environment with occasional travel and in office meetings.

We are The Dentist Insurance Company (TDIC), and we promise to protect only dentists, protect them better than any other insurance company and be there when they need us.

TDIC was founded in 1980 by a small group of California Dental Association members in response to skyrocketing malpractice premiums that impacted dentists’ ability to practice productively and patients’ ability to access care. Since that time, we’ve grown to protect 24,000+ policyholders across 15 states with a comprehensive suite of dentist-centric insurance products and risk management tools. With this singular focus and the unparallelled expertise of people who understand dentistry, we’ve earned the trust of our community.

TDIC has been rated A (Excellent) by AM Best for financial stability for 28 consecutive years, as well as the Best of Insurance award from ClearlyRated for client satisfaction. We’ve also earned endorsements from nine dental associations.

At TDIC, we seek out, welcome and support the best and brightest individuals across unique specialties and prioritize diversity in our hiring practices. Remote and hybrid flexibility and technology to support remote work

• Generous time off program starting at 22 days of PTO and13 paid holidays (includes a floating holiday and winter closure)
• Highly competitive medical, dental and vision plans, including FSA and HSA account options
• Opportunities for professional development, training and leadership skill-building
• Critical illness, accident, life, pet, short term and long-term disability insurance options
• Employee Assistance Program (EAP) for support navigating day-to-day challenges

Cultivates relationships, builds partnerships, shares and learns without boundaries.

• nurture and promote an environment that values diversity of thought, input, experience and expertise.

Applies analysis, creativity, resilience and logic to reach optimal outcomes; clarifies purpose, evaluates alternatives and analyzes risks

Working under close supervision to investigate and make determinations related to cause and origin of loss and liability, including retaining and supervising outside adjusters, legal counsel and other vendors, to ensure efficient adjustment of claims. The Claims Representative II will also work with the claims supervisor to continually evaluate and establish appropriate case values and reserves.

Working with claims supervisor to manage the course of litigation including, the development of defense strategies and budgets in accordance to TDIC Litigation Guidelines. The Claims Representative II may attend meetings with policyholders, defense attorneys, and consultants.

The claims representative may also negotiate claim resolutions with claimants and/or their legal representatives under the direction of the claims supervisor.

The claims representative may also negotiate resolutions with policyholders and identify, manage, and resolve all issues related to subrogation of claims with the assistance of the supervisor.

Maintaining assigned caseloads on a diary system, including, documenting claim files and timely corresponding with insureds, vendors, claimants and/or their legal representatives. The Claims Representative may be responsible for reviewing vendor bills, challenging billed items when appropriate and with supervisor guidance, approving payments.

Reviewing new claims with the supervisor to determine an appropriate course of action.

Identifying cases of significance with the assistance of the supervisor, and preparing appropriate requests for authority from supervisor, management, and/or the Board.

Attending mandatory meetings and pursuing educational opportunities, including seminars, insurance courses, workshops, and in-house training, with approval from the claims supervisor.

High school diploma or GED.

Requires a minimum of three years insurance experience in a liability claims or similar position; Requires intensive communication with involved parties via phone.

Must be able to perform job duties under supervision.

Requires computer skills, including the ability to operate MS Windows Office, including experience with AS400 or other database management program.

Regular auto/air travel required.

Associate’s or Bachelors’ degree with courses in insurance preferred.

Commercial property insurance and in-person negotiation experience preferred.

Experience with claims management and estimating software programs preferred.

Constantly reviewing and analyzing data on a computer screen.

Occasional auto/air travel required.

Occasional overnight travel as needed.

Over our 150-year history, the California Dental Association (CDA) has become a leader in oral health throughout California and the country. Today, we continue to support our community of over 27,000 dentists through our family of companies, which include The Dentists Insurance Company (TDIC), TDIC Insurance Solutions, Rotunda Partners and the CDA Foundation.

CDA does not tolerate discrimination or harassment and all employment decisions are based on job requirements and individual qualifications, without regard to race, color, religion, national origin, age, gender, gender identity or expression, sex, ancestry, citizenship status, mental or physical disability, genetic information, sexual orientation, veteran or military status. If you have a disability or special need that requires accommodation, please contact us at .

To see our privacy policy, go to