Job Details
Description
The Doctors Company is seeking an experienced Claims Specialist for our Region II (Northeast) team. This position will be a telecommuter role and the successful candidate can be located anywhere in our region but will have responsibility for claims in the states of Illinois, Missouri and Michigan.
The Claims Specialist independently and pro-actively manages the medical malpractice claims for assigned members. Monitors and reviews all new claims for designated members and establishes a plan of action to achieve a favorable claim resolution. Attends and facilitates member meetings and claim reviews. Reviews and recommends appropriate case reserves. Negotiates settlements when appropriate and attends trial and provides insights and analysis. Advocates, consults, and serves as a trusted resource and partner with physician members.
Responsibilities:
- Completes initial coverage analysis
- Develops a plan of action on assigned cases in conjunction with defense counsel and supervisor
- Interview insureds within performance standards/guidelines
- Consults with external stakeholders (insured, claimant, defense attorney, plaintiff attorney) to optimize results of the overall investigation and discovery process
- Interfaces with insured member to provide ongoing support and disclosure of investigation results to keep the member fully informed
- Makes recommendation for assignment of litigated matters to appropriate defense panel members
- Partners with defense counsel for optimum outcome on all assigned cases
- Monitors and approves fees and expenses within authority
- Evaluates facts, allegations, liability and damages issues and maintains appropriate case reserves
- Recommends the proper course of resolution to regional leadership based on the investigation and discovery
- Attends mediations, settlement conferences, arbitrations, and trials as necessary
- Provides risk/benefit analysis to the member
- Supports the member throughout the life of the claim file up to and through trial
- Other duties as assigned
Education (and/or equivalent experience) required.
- Bachelor’s degree or equivalent combination of education and experience required.
- Juris Doctorate preferred.
- Three to five (3-5) years of medical malpractice or equivalent claims-related experience.
- Prior claims experience in Illinois, Missouri and Michigan is a plus.
