Claims Management Specialist

2 weeks ago


Schaumburg, Illinois, United States OMS NATIONAL INSURANCE CO Full time
Job Overview

At OMS National Insurance Co., our commitment is clear: we are focused on supporting and safeguarding oral and maxillofacial surgeons as well as dental professionals across the nation. If you possess expertise in legal or claims processes and are looking to contribute to a reputable leader in the industry, OMSNIC may be the ideal fit for you.

We provide a comprehensive benefits package designed to enhance the well-being of our employees, including generous paid time off, a long-term incentive program, affordable and extensive health plans, a flexible work environment, educational assistance, and pathways for career advancement. Our unique collaborative culture and the collective impact we achieve as a team set us apart.

Responsibilities of Claims Analysts

  • Assess coverage and policy details
  • Coordinate with defense attorneys
  • Examine and interpret medical documentation
  • Investigate and assess liability, causation, and damages, proactively advancing claims towards resolution
  • Engage in the development of case strategies
  • Negotiate settlements with a focus on resolution
  • Evaluate indemnity and expense reserves
  • Draft detailed Claim Reports
  • Present claims for management review
  • Keep policyholders updated on claim status
  • Accurately document all claim activities
  • Maintain claim data for precise reporting
  • Review and authorize billing statements

General Duties

  • Participate in Risk Management and Defense Counsel seminars
  • Contribute to departmental and organizational objectives and initiatives
  • Engage in training and development programs as needed
  • Assist in the onboarding and training of new team members

Qualifications:

  • A Bachelor's Degree is required; equivalent professional experience may be considered
  • A Juris Doctorate is preferred but not mandatory
  • A minimum of 3 years' experience in legal, insurance, or medical professional liability claims management is essential
  • Familiarity with medical records is important
  • Proficiency in Microsoft Office Suite, particularly Word, Excel, and PowerPoint

Key Competencies:

  • Excellent organizational and time management abilities, with a strong capacity to meet deadlines
  • Effective verbal and written communication skills for clear information dissemination and stakeholder interaction
  • Strong analytical and critical thinking skills for fact analysis and issue resolution
  • Ability to prepare comprehensive reports while providing a broad overview when necessary
  • Exceptional customer service skills and active listening capabilities
  • Strong interpersonal skills for interaction with policyholders, legal professionals, management, colleagues, and external vendors
  • Proficient mediation and negotiation skills

Work Environment:

  • Work is performed in an office setting, with hybrid opportunities available at management's discretion

Base salary range is $75,000-$125,000. Individual compensation packages are determined by various factors unique to each candidate, including experience, qualifications, and education.



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