Claims Specialist
4 weeks ago
At OMS National Insurance Co., we are dedicated to serving and protecting oral and maxillofacial surgeons and dental professionals nationwide. As a Claims Analyst, you will play a critical role in managing an assigned caseload of claims, investigating, evaluating, and resolving both pre-litigation and litigated matters.
Key Responsibilities:- Evaluate coverage and assign defense counsel
- Review and analyze medical records to investigate and evaluate issues of liability, causation, and damages
- Participate in the formulation of case strategy and negotiate claims in a settle posture
- Evaluate indemnity and expense reserves, prepare Comprehensive Claim Reports, and present claims to management and for internal review
- Keep policyholders informed of the status and timely and accurately document claim files
- Bachelor's Degree required; might 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 and Microsoft Office Suite proficiency with emphasis on Word, Excel, and PowerPoint
- 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 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
Base salary range is $75,000-$125,000. Individual compensation packages are based on variety of factors that are unique to each candidate, including experience, qualifications, and education.
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