Senior Claims Examiner - Healthcare

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Senior Claims Examiner - Healthcare

The candidate will investigate, evaluate and resolve Healthcare claims. Develop and implement a strategy to resolve matters of liability and damages of a particular case. Analyze coverage, liability and damages for purposes of assessing and recommending reserves. Prepare and present written and oral reports to senior management setting forth all issues influencing evaluation and recommending reserves. Manage excess accounts and perform audits. Identify and assess coverage issues and draft coverage position letters. Maintain contact with the insured, underwriter, primary adjuster, counsel retained by the primary carrier and the broker. Make decisions on whether to retain monitoring counsel, request tender of defense from the primary or proceed with the litigation utilizing counsel retained by the primary. Retain counsel when necessary and direct counsel in accordance with the resolution strategy. Attend mediations, trials, and other proceedings relevant to the resolution of the matter. Travel to and from such locations within the United States. Select and utilize structure brokers. Process invoice and indemnity payments. Bachelor’s degree; Juris Doctorate degree preferred. Should have 5 years of working experience supporting commercial accounts for Healthcare claims including claims. Proper & active adjuster licensing in all applicable states. Exceptional communication (written and verbal), evaluating, influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines. Strong time management and organizational skills. Ability to take part in active strategic discussions. Ability to work well independently and in a team environment. Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word. Willing and able to travel 10%.

Additional Information

ID: 2022-6147.

Company info

Arch Capital Group Ltd.
300 Plaza Three 3rd Floor
Jersey Cit
New Jersey
United States 07311
Website : https://www.archcapgroup.com/