Talent.com
Claims Specialist

Claims Specialist

Primma, LLCRochester, NY, US
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Job Description

Job Description

  • This role is onsite at our Roslyn, NY or Rochester, NY office, with the option for a hybrid schedule after the training period.

General Summary : A Claims Specialist will utilize their experience in medical liability claim handling to investigate, evaluate, and resolve high exposure claims while demonstrating a strong commitment to exceptional client service.

Essential Duties & Responsibilities :

  • Follow standard claims protocols for documentation, coverage verification, and file management
  • Maintain accurate and organized claims files, suggesting improvements as necessary
  • Assist in client relationship management, collaborate with underwriting on marketing
  • Investigate and document most significant exposures, setting appropriate indemnity and expense reserves
  • Develop resolutions strategy and participate in negotiations to 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 strong technical knowledge 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
  • Five years’ claims handling experience required; medical professional liability 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 collaboratively within a team. Set a strong example 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.

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