Senior Resolution Specialist- Medical Malpractice- Healthcare

Gallagher; Houston (TX); Remote; USD 120,000 - 165,000; Full time

Job summary

A leading insurance firm is seeking an experienced Claims Adjuster with a Medical Malpractice background. The role involves investigating, evaluating, and resolving complex claims while maintaining high standards of client service. Candidates must possess at least 5 years of experience, relevant licenses, and strong analytical skills. The position offers a competitive salary and the flexibility of fully remote work.

Benefits

Medical, dental, and vision plans

401(K) and Roth options

Training programs

Paid parental leave

Flexible work hours

Qualifications

• Minimum of 5+ years of experience handling claims in Medical Malpractice.
• Ability to handle complex claims issues at a senior adjuster level.
• Licensed or able to acquire necessary licenses.

Responsibilities

• Investigate and resolve complex claims.
• Work with clients to improve claims management.
• Provide guidance and mentorship to junior adjusters.

Skills

Claims handling expertise

Analytical skills

Negotiation capabilities

Problem-solving

Education

High school diploma

Bachelor's Degree

Law Degree (JD)

Tools

Claims management software

Job description

Overview

Salary: up to $165,000 per year, dependent upon experience Jurisdictions: Open to Any Licenses: must be willing to obtain all licenses stated by manager within specified timeframe Location: This role is eligible for fully remote work. Claims Background: Medical Malpractice - Healthcare

How you'll make an impact

Analyzes coverage and settles the most complex and challenging claims within Gallagher Bassett’s specialty claims areas (excluding workers' compensation). Handles the full life cycle of all assigned claims files, from intake to resolution. Determines coverage applicability and defense obligations independently. Conducts thorough investigations and analysis to assess exposure and develop settlement strategies and action plans. Drafts and issues reservation of rights and coverage denial letters. Negotiates settlements with clients, client attorneys, and Public Adjusters. Engages with all parties involved in the claims process; may recommend retaining outside experts when appropriate. Prepares reserve and settlement authority requests for both client and carrier approval. May act as a client advocate with carriers to ensure proper handling of claims, including scoping, estimating, and addressing coverage issues. Possesses solid understanding of claims processing and the insurance brokerage business. Demonstrates deep knowledge of industry-specific terminology, case law, and specialized claims areas. Handles claims in alignment with client and corporate policies, best practices, and all regulatory and ethical standards. Provides guidance and mentorship to junior adjusters. Capable of handling a full caseload independently and effectively.

About You

Potential candidates should have the following : Claims Background : Medical Malpractice – Healthcare Jurisdictional Experience : Any Active Adjusters' licenses : must be willing to obtain all licenses stated by manager within specified timeframe

As a key member of our Claims Adjuster team, you will

Investigate, evaluate, and resolve complex Medical Malpractice claims, applying your claims experience and analytical skills to make informed decisions and bring claims to resolution. Work in partnership with our clients to deliver innovative solutions and improve the claims management process. Think critically, solve problems, plan, and prioritize activities to optimally serve clients.

REQUIRED QUALIFICATIONS

High school diploma. Minimum of 5+ years of experience handling claims within the applicable specialty area (Medical Malpractice). Proven ability to handle complex and challenging claims issues at a senior adjuster level. Licensed and / or certified in all applicable states, or able to acquire necessary licenses per local requirements. Familiarity with accepted industry standards and practices. Proficient with relevant claims management and business software.

DESIRED

Bachelor's Degree, Law Degree (JD). Litigation experience. 10+ years of prior experience adjusting claims in applicable specialty area. Experience in claims as well as the insurance legal and regulatory environment.

Compensation and Benefits

We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market / geography, complexity or scope, specialized skill set, lines of business / practice area, supply / demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits. Below are the minimum core benefits you’ll get, depending on your job level these benefits may improve : Medical / dental / vision plans, which start from day one! Life and accident insurance 401(K) and Roth options Tax-advantaged accounts (HSA, FSA) Educational expense reimbursement Paid parental leave.

Other benefits include

Digital mental health services (Talkspace) Flexible work hours (availability varies by office and job function) Training programs Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing Charitable matching gift program And more...

Benefits Summary

• The benefits summary above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process.