Senior Claims Examiner, Healthcare

• Manage and adjust healthcare claims impacting primary, umbrella and excess policies while ensuring the highest level of customer service and technical claim file quality
• Proactively handle claims from first notice of loss through ultimate resolution while working with and advising internal partners and meeting with clients and brokers
• Ongoing collaboration and partnership with the insured, broker and TPA in the handling and adjudication of claims
• Analyze and draft coverage letters as appropriate and communicate coverage positions effectively
• Conduct, coordinate, and proactively handle the investigation process and ensures timely resolution of claims
• Direct and closely monitor assignments to experts and defense counsel as necessary
• Evaluate information on coverage, liability and damages to determine the extent of exposure to the insured and the company
• Draft reports set reserves within the authority or make claim recommendations concerning reserve changes
• Travel to conferences, mediations, and trials as necessary

• High degree of specialized and technical competence in the handling of claims
• 5-10 plus years of healthcare claim handling experience or matching equivalency
• College degree required
• Ability to work independently and assimilate learning materials on many different subjects from various sources
• Excellent interpersonal, communication and negotiation skills
• Ability and willingness to work effectively in a team environment and handle multiple tasks simultaneously
• Experience in handling and adjusting claims in multiple jurisdictions and must possess, or be willing to obtain, required licenses

JD preferred

• Comprehensive Health, Dental and Vision benefits
• Disability Insurance (both short-term and long-term)
• Life Insurance (for you and your family)
• Accidental Death & Dismemberment Insurance (for you and your family)
• Flexible Spending Accounts
• Health Reimbursement Account
• Employee Assistance Program
• Retirement Savings 401(k) Plan with Company Match
• Generous holiday and Paid Time Off
• Tuition Reimbursement
• Paid Parental Leave
• annual bonus eligibility