Senior Resolution Specialist- Medical Malpractice- Long Term Care

Gallagher; Houston (TX); Remote; USD 140,000 - 165,000; Full time

Job summary

A leading insurance company is seeking an experienced Senior Claims Adjuster to analyze and resolve complex medical malpractice claims. This role offers a competitive salary up to $165,000 per year and the opportunity for fully remote work. Candidates should have at least 5 years of experience in claims handling and be willing to acquire necessary licenses. Comprehensive benefits include flexible work hours, medical plans, and educational reimbursement.

Benefits

Medical/dental/vision plans

401(K) and Roth options

Paid parental leave

Educational expense reimbursement

Digital mental health services

Flexible work hours

Qualifications

• Minimum of 5 years of experience handling claims within Medical Malpractice.
• Proven ability to handle complex claims issues at a senior adjuster level.
• Must be willing to obtain necessary licenses per local requirements.

Responsibilities

• Analyzes coverage and settles complex claims.
• Handles full life cycle of assigned claims files.
• Negotiates settlements with clients and attorneys.

Skills

Claims Background in Medical Malpractice

Analytical Skills

Effective Communication

Education

High School Diploma

Bachelor's Degree

Law Degree (JD)

Tools

Claims Management Software

Business 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 – Long Term Care

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 – Long Term Care
• 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…

**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.We value inclusion and diversityto review our U.S. Eligibility RequirementsInclusion and diversity (I&D) is a core part of our business, and it’s embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work.Gallagher embraces our employees’ diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest.Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as “protected characteristics”) by applicable federal, state, or local laws.Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.

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