Complex Claims Specialist at Primma, LLC

Roslyn, New York, United States -

Full Time

Start Date

Immediate

Expiry Date

22 Jun, 26

Salary

148000.0

Posted On

24 Mar, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Claims Handling, Medical Liability, Client Service, Documentation, Coverage Verification, File Management, Indemnity Reserves, Expense Reserves, Negotiation, Litigation Strategy, Mentoring, Data Integrity, Analytical Skills, Problem-Solving, Business Writing, Oral Communication

Industry

Insurance

Description

**This role is onsite at our Roslyn, NY, Rochester, NY, or Hamilton, NJ office, with the option for a hybrid schedule after the training period. ** General Summary: A Complex Claims Specialist will possess experience in handling complex medical liability claims, while demonstrating a strong client service focus. Essential Duties & Responsibilities: * Follow standard claims protocols for documentation, coverage verification, and file management * Maintain accurate and organized claims files, suggesting improvements as necessary. * Manage significant client relationships for claims department, collaborate with underwriting on marketing. * Investigate and document most significant exposures, setting appropriate indemnity and expense reserves * Develop resolutions strategy and lead negotiations and bring matters to a close * Attend trials and mediations when necessary * Adhere to industry Best Practices for effective claim management * Mentor staff through formal and informal training and development; demonstrate extensive technical expertise to guide and support less experienced claims professionals * Ensure exceptional data integrity * Actively manage defense council and partner on litigation strategy * Proactive communication with insureds, other departments and claim leadership * Perform additional duties and responsibilities as assigned Education & Qualifications: * Bachelor’s degree or JD required * Six years’ claims handling experience required; medical professional liability strongly preferred * NY adjusters license required within the first 6 - 12 months of employment * Strong analytical and problem-solving skills with attention to detail * Demonstrate solid and concise business writing proficiency * Exhibit strong oral communication skills to include presenting information clearly and effectively to diverse audiences * Ability to work independently as well as assume a mentorship role within a team. Act as a strong example and resource for less experienced colleagues * Strong ethical judgement and a commitment to maintaining confidentiality * Must be able to work on site * Travel required as needed; may include overnight travel The actual compensation for this position will be determined by experience and other factors permitted by law.

Responsibilities

The specialist will manage complex medical liability claims by following standard protocols for documentation, investigation, and reserve setting, while also leading negotiations to bring matters to a close. This role involves maintaining significant client relationships, collaborating with underwriting, and actively managing defense counsel and litigation strategy.