Job Type:
Permanent
Build a brilliant future with Hiscox
Our Senior Complex Claims Specialist - Allied Healthcare is an individual contributor role, responsible for the handling of mostly high-severity primary Allied Healthcare Professional Liability claims from inception to resolution. This includes, but is not limited to, mental health counseling practices, social services, medical spas, home health aid and healthcare staffing agencies, pharmacies and testing laboratories.
The role is responsible for all aspects of the claims and litigation process, including liaising with external and internal business partners (e.g., outside experts and/or legal counsel; underwriting) as required.
This Role:
Acts as subject matter expert within the team
Models gold standard for litigation best practices and file integrity
Identifies and provides potential solutions for emerging exposures and claims trends
Identifies suspected fraudulent claims and tracks with special investigations unit
With minimal supervision, adjusts to resolution the highest severity claims and drafts the most complex technical coverage analysis and letters required
Uses superior knowledge and experience to affect positive claim outcome via investigation, negotiation and utilization of alternative dispute resolutions, including identifying appropriate matters for trial
Accurately documents claim files with all relevant correspondence and notes in compliance
The Team:
The US Claims team at Hiscox is a growing group of professionals working together to provide superior customer service and claims handling expertise. The claims staff are empowered to manage their claims within given authority to provide fair and fast resolution of claims for our insured and broker partners. With strong growth across the US business, the Claims team is focused on delivering profitability while reinforcing Hiscox’s strong brand built on a long history of outstanding claims handling.
Requirements:
10+ years of Professional Liability and/or Medical Malpractice liability handling experience.
B.A./B.S Degree required, JD optimal
JD from an ABA accredited law school may be considered as a supplement to claims handling experience
Adjuster licensing is required within 90 days of employment
Proven ability to positively affect complex claims outcomes through investigation, negotiation and effectively leading litigation
Ability to work in a fast-paced and changing environment
Advanced knowledge of coverage within the team’s specialty or focus
Advanced knowledge of litigation process and negotiation skills
Experience in mentoring and training other claims examiners
Excellent verbal and written communication skills
Advanced analytical skills
Proven ability to positively affect highest severity claims outcomes through investigation, negotiation and effectively leading litigation and managing defense counsel and claim strategy.
Additional Factors to Consider:
Subject matter expertise or technical leadership in other lines of business and/or claim types
Demonstrates ability to work with minimal oversight
Demonstrates ability to advance product innovation or develop a greater understanding of other aspects of the business through training or other relevant projects across teams of lines of business
Demonstrates courage and confidence in addressing and solving difficult or severity matters with insureds, attorneys, and brokers
What Hiscox USA offers:
Competitive salary and bonus (based on personal & company performance)
401(k) with competitive company matching
Comprehensive health insurance, vision, dental and FSA plans (medical, limited purpose, and dependent care)
Company paid group term life, short- term disability and long-term disability coverage
24 Paid time off days, 2 Hiscox Days, 10 paid holidays, and ability to purchase 5 PTO days
Paid parental leave
4 week paid sabbatical after every 5 years of service
Financial Adoption Assistance and Medical Travel Reimbursement Programs
Annual reimbursement up…