Senior Complex Medical Malpractice Claims Specialist

CNA Insurance; Wyomissing (Berks County); Hybrid; USD 72,000 - 141,000; Full time

Job summary

CNA Insurance in the United States is seeking a Complex Claims Consultant to support diverse healthcare provider segments. You will investigate and manage high-exposure claims across multiple states, applying policy interpretation, reserving, and collaboration with underwriting for insights.

The role requires a Bachelor's degree or equivalent, typically six years of relevant experience in claims or medical malpractice litigation, and an Insurance Adjuster License within 90 days.

Qualifications

• Bachelor's degree or equivalent experience.
• Typically a minimum six years of relevant experience, preferably in claim handling or medical malpractice litigation.
• Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable.
• Prior negotiation experience.
• Professional designations preferred (e.g. CPCU).

Responsibilities

• Manages an inventory of highly complex commercial claims, with large exposures that require a high degree of specialized technical expertise and coordination.
• Ensures exceptional customer service by managing all aspects of the claim and responding promptly to inquiries.
• Verifies coverage and establishes timely reserves by reviewing policy language and coordinating with coverage counsel.
• Leads focused investigations to determine compensability, liability and damages.
• Resolves claims by collaborating with internal and external partners to execute a resolution strategy.
• Establishes and manages claim budgets with timely resolution and resource oversight.
• Addresses subrogation/salvage opportunities and potential fraud occurrences.
• Keeps leadership informed of significant risks via loss summaries and oversight lists.
• Maintains expertise and regulatory compliance with state/local requirements.
• Mentors and trains less experienced Claim Professionals.

Skills

Complex claims handling

Analytical mindset

Negotiation

Communication skills

Regulatory compliance

Time management

Team collaboration

Education

Bachelor's degree or equivalent

Insurance Adjuster License within 90 days

Tools

Microsoft Office

Job description

CNA Insurance in the United States is seeking a Complex Claims Consultant to support diverse healthcare provider segments. You will investigate and manage high-exposure claims across multiple states, applying policy interpretation, reserving, and collaboration with underwriting for insights.

The role requires a Bachelor's degree or equivalent, typically six years of relevant experience in claims or medical malpractice litigation, and an Insurance Adjuster License within 90 days.