Medical Liability Claims Specialist

2 weeks ago

Concord, California, United States Adecco USA Full time

Adecco USA is partnering with a leading organization to find a Liability Claims Advisor for a remote position in California. The salary range for this role is up to $129,000 based on experience, and a Bachelor's Degree is required.

Key Responsibilities:

  • Analyze and manage complex medical professional liability claims by conducting thorough investigations and gathering relevant information to assess claim exposure.
  • Oversee claims through well-structured action plans, ensuring timely and appropriate resolutions.
  • Conduct or delegate comprehensive investigations and provide detailed reports on new claims and legal actions.
  • Negotiate settlements within designated authority limits and establish appropriate reserves for claims, monitoring their adequacy throughout the claim lifecycle.
  • Formulate settlement strategies and present structured proposals to optimize outcomes.
  • Perform coverage analyses and provide expert opinions as part of the claims process, ensuring all necessary correspondence is completed.
  • Coordinate legal defense by selecting attorneys, facilitating investigations, and reviewing legal invoices while ensuring compliance with client guidelines.
  • Implement cost containment strategies, leveraging strategic vendor partnerships to minimize overall claim expenses.
  • Identify potential fraud, subrogation, and recovery opportunities to further reduce claim costs.
  • Represent the company in depositions, mediations, and trial monitoring as required.
  • Maintain professional relationships with clients, ensuring clear communication regarding claim activities and processing.
  • Ensure all claim files are accurately documented and properly coded.
  • Refer cases to supervisors and management as necessary, while mentoring and delegating tasks to team members.

Qualifications:

  • Bachelor's degree from an accredited institution is mandatory.
  • Professional certification relevant to the line of business is preferred.
  • A minimum of six years of experience 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 relevant laws.
  • Expertise in claims management, including strong analytical and interpretive skills.
  • Proficient in Microsoft Office and other relevant software.
  • Exceptional oral and written communication skills, including presentation abilities.
  • Strong organizational and negotiation skills, with the ability to work collaboratively in a team environment.

Compensation: The position offers a salary range of $122,000.00 to $129,000.00 annually.

Benefits: Adecco USA provides a comprehensive benefits package that includes medical, dental, vision, life insurance, short-term disability, and additional voluntary benefits. Employees can also participate in a 401K plan and may be eligible for paid leave, including sick leave and holiday pay, as mandated by applicable laws.

Adecco USA is an Equal Opportunity Employer and welcomes applicants from diverse backgrounds.

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