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Medical Professional Liability Claims Representative
2 months ago
**Responsibilities**:
- Investigate, evaluates, and negotiates or otherwise resolves claims assigned with Texas and/or other states.
- Analyzes coverage and drafts appropriate correspondence to policyholders.
- Ensures proper evaluation and reserving of assigned claims.
- Develops claim files on assigned cases, documenting all transactions related to file handling.
- Reports progress and results in a timely manner and in accordance with claim department directives.
- Negotiates directly with claimants and/or their legal representatives and is responsible for prompt and proper disposition of all claims within delegated authority.
- Selects and assigns defense counsel; works closely with defense counsel to control their use of discovery proceedings and to ensure effective defense of suits.
- Manages expenses including reasonableness of attorneys' fees.
- Seeks standard of care opinions from outside consultants. Suggests additions and/or deletions to consult list.
- Attends and monitors trials.
- Coordinates and participates in Litigation Management reviews for selected defense firms.
- Completes state board of insurance reporting form (if required) and national data bank reporting form (if required), upon closing a claim.
- Attends defense meetings with attorneys and policyholders when appropriate.
- Attends and participates in mediations including the direction of negotiations, if any.
**Desired Skills**
- Strong analytical skills.
- Effective oral and written communication skills.
- Knowledge and understanding of basic professional liability insurance contracts, regulations, and litigation.
- Five years of progressively responsible experience in the casualty insurance field handling bodily injury claims (physicians' liability experience preferred).
- Bachelor's degree and Adjuster's License required. Incumbent meeting other selection criteria except possession of Adjuster's License will be required to obtain license within six months of employment.
**Other**
This is an Austin based hybrid model position and requires the availability for some travel including overnight stays. Any offer of employment is conditioned upon satisfactory completion of a background and driving record verification.
Pay: $70,000.00 - $164,000.00 per year
**Benefits**:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Flexible schedule
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Professional development assistance
- Referral program
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Work setting:
- Hybrid work
- Office
Work Location: Hybrid remote in Austin, TX 78746
