Senior Medical Liability Claims Specialist

2 weeks ago


Concord, California, United States NESCO Inc Full time
Position Overview:

We are seeking a highly skilled Senior Medical Liability Claims Specialist to join our team at NESCO Inc. This role is essential for managing complex medical malpractice claims and ensuring effective resolution in line with industry standards.


Key Responsibilities:
  • Analyze and process intricate medical professional liability claims, gathering essential information to assess exposure.
  • Develop and implement action plans for timely resolution of claims.
  • Conduct thorough investigations and compile comprehensive reports on new claims and legal actions.
  • Negotiate settlements within designated authority levels and recommend strategies to maximize outcomes.
  • Perform coverage analysis and ensure all necessary correspondence is completed.
  • Coordinate legal defense by assigning attorneys and overseeing compliance with client guidelines.
  • Utilize cost containment techniques to minimize overall claim costs for clients.
  • Identify opportunities for fraud investigation, subrogation, and recovery.
  • Represent the company in depositions, mediations, and trial monitoring as required.
  • Maintain professional relationships with clients and communicate claim activities effectively.
  • Ensure accurate documentation and coding of claim files.
  • Mentor junior staff and delegate tasks as appropriate.

Qualifications:

Education: Bachelor's degree from an accredited institution is required. Professional certification relevant to the line of business is preferred.

Experience: A minimum of six years in medical malpractice claims management or a comparable combination of education and experience is preferred.


Skills and Knowledge:
  • Comprehensive understanding of medical malpractice insurance principles and applicable laws.
  • Expertise in claims management with a focus on medical malpractice.
  • Exceptional communication skills, both oral and written.
  • Proficient in Microsoft Office and other relevant software.
  • Strong analytical, organizational, and negotiation skills.
  • Ability to work collaboratively in a team environment.

NESCO Inc. is committed to fostering an inclusive workplace and provides equal employment opportunities to all employees and applicants without discrimination.



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