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Claims Specialist

2 months ago

Schaumburg, Illinois, United States OMS NATIONAL INSURANCE CO Full time
Job Opportunity at OMS National Insurance Co.

Job Summary:

OMS National Insurance Co. is seeking a highly skilled Claims Analyst to join our team. As a Claims Analyst, you will play a critical role in managing an assigned caseload of claims, investigating and evaluating issues of liability, causation, and damages, and negotiating claims in a settlement posture.

Key Responsibilities:

  • Claims Management:
    • Evaluate coverage and assign defense counsel
    • Review and analyze medical records
    • Investigate and evaluate issues of liability, causation, and damages
    • Negotiate claims in a settlement posture
    • Evaluate indemnity and expense reserves
    • Prepare Comprehensive Claim Reports
    • Present claims to management and for internal review
    • Keep policyholders informed of the status
    • Timely and accurately document claim files
    • Help maintain claim file data for accurate reporting
    • Review and approve bills
  • General:
    • Participate in Risk Management and Defense Counsel Seminars
    • Contribute to departmental and company goals, initiatives, and projects
    • May attend or participate in training and development programs
    • May participate in the training and development of new hires

Requirements:

  • Bachelor's Degree required; may consider a demonstrated equivalent professional experience
  • JD preferred, but not required
  • Minimum 3 years' experience in the legal, insurance, or medical professional liability claims management field
  • Working understanding of medical records
  • Microsoft Office Suite proficiency with emphasis on Word, Excel, and PowerPoint

Competencies:

  • Strong organizational and time management skills, ability to meet deadlines
  • Effective written and oral communication skills to provide information in a clear and concise manner and to communicate with a variety of stakeholders
  • Effective analytical and critical thinking skills to analyze facts and draw conclusions to make recommendations and resolve issues
  • Ability to prepare robust reporting yet provide a broad scope overview and summary, when appropriate
  • Superior customer service skills and ability to actively listen
  • Strong interpersonal skills with ability to interact with policyholders, legal professionals, management, co-workers, agents, committee, and board members, and external vendors
  • Strong mediation and negotiation skills

Work Environment:

  • Performs work in an office environment (hybrid opportunity at manager's discretion)

Base salary range is $75,000-$125,000. Individual compensation packages are based on a variety of factors that are unique to each candidate, including experience, qualifications, and education.