Claim Consultant

Coverys

1d

About The Position

The Senior Claim Consultant provides complete claim loss services for policyholders. Investigates, evaluates, and disposes of MPL and General Liability claims with varying degrees of complexity and severity. If you're a caring and customer focused individual who enjoys working with passionate team members, Coverys is the right company for you! They say an organization is only as good as its people. Here at Coverys, we believe that our employees are our most valuable asset. Each of our positions is thoughtfully crafted to ensure alignment with our mission, and every opportunity to join our team is an opportunity to support and protect the healthcare community. Our open positions offer you the chance to join a team of compassionate, dedicated, and resilient employees who are committed to becoming the best in the business. We are an organization committed to growth and professional development, keeping up to date with changes in the healthcare industry to ensure we're providing our insureds with the best possible support. All the while, we are committed to our employees and listen to the needs of our internal talent. Our benefits package is available day 1 of employment, so you never miss a beat. There is truly something for everyone in our benefits package, whether you are raising a family or a furry friend, or you're an avid traveler who uses PTO to chase down your next adventure. The important work done by Coverys employees is not limited to what's done at our desks. Throughout the year, we provide ample opportunities to get involved in our local communities. We get involved, we raise money, and we give back. Connecting with colleagues takes on new meaning when you're elbow-deep planting trees or rolling up your sleeves serving lunch to those in need. The giving doesn't end there—Coverys cares about the initiatives near and dear to your heart. That's why we offer directed donations, as well as company matchings, to support the organizations that you are personally involved with. Coverys is a dynamic organization, with opportunities to join our team across the US, as well as internationally in the UK and Ireland. Coverys is an equal-opportunity employer. Coverys’ job openings are open to all without regard to race, color, national origin, gender, gender identity, religion, age, height, weight, disability, political beliefs, sexual orientation, marital status, family status, or veteran status.

Requirements

• Bachelor's degree from four-year college or university.
• R.N. or J.D. preferred with 5 years’ experience in clinical nursing and/or 5 years claims experience dealing with serious bodily injury.
• Insurance adjuster's license may be required for specific states.
• Knowledge of medical, legal and insurance terminology is required.
• Must hold a current driver's license.
• Strong written and oral communication skills.
• Must be comfortable making oral presentations to staff and insureds.
• Must have training in contract/policy review and application.
• Ability to read, analyze, and interpret insurance policy coverage forms, professional journals, technical procedures, or government regulations.
• Ability to write reports, business correspondence, and technical case summaries.
• Ability to effectively present information and respond to questions from groups of managers, insured's, agents and attorneys.
• Must be able to synthesize complex or diverse information; collect and research data; use intuition and experience to complement data; design workflows and procedures.
• Must have the ability to design and generate creative solutions.
• Experience with Microsoft Word, Excel, PowerPoint.
• Able to work with minimal supervision on a day-to-day basis.
• Occasional overnight travel may be required of this position (up to 25%).

Responsibilities

• Interview insureds, claimants, witnesses, and other appropriate parties to obtain information used to assess liability exposure.
• Document file regarding results of investigation and negotiations.
• Prepare reports to file on established diary dates and other specific reports as needed to ensure timely file documentation and plan of action.
• Secure records for investigation and evaluation of cases.
• Determine and implement negotiation strategy and negotiates settlements within authority level.
• Adjust reserves within level of authority and make reserve recommendations to Manager/Director for amounts over position authority level.
• Evaluate cases for appropriate disposition and seek authority for settlement from manager/director when settlement amount requests exceed authority.
• Direct and monitor activities of defense counsel in compliance with Case Management Guidelines.
• Monitor trials and attend pre-trial proceedings, mediations, and arbitrations as necessary.
• Identify significant insured Risk Management or Underwriting issues and direct the information to appropriate department.
• Communicate with insureds, claimants, and witnesses; consult medical and other relevant records, varying methods of investigation according to type of claim.
• Analyze losses to determine if insurance coverage applies.
• Maintain working knowledge of policy forms and can confirm policy in effect for date of loss.
• Performs other duties as assigned.

Benefits

• Our benefits package is available day 1 of employment, so you never miss a beat.
• There is truly something for everyone in our benefits package, whether you are raising a family or a furry friend, or you're an avid traveler who uses PTO to chase down your next adventure.
• That's why we offer directed donations, as well as company matchings, to support the organizations that you are personally involved with.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level