Healthcare Lead Claims Specialist

To provide ultimate claim service for insurance claim matters presented by clients of Risk Strategies Inc., and affiliates, in accordance with objectives and procedures outlined by management.

Your Impact

• Receive loss reports from Healthcare Clients and confirm that the claims are filed under the appropriate policy(ies)
• Research policy terms and stipulations to determine coverage applicability and advocate for maximum recovery.
• Strong understanding of all lines of insurance policies, coverage, and relevant regulations.
• Educate and address questions from Clients regarding claim reporting requirements
• Advocate for the client, maintaining an active diary, transmittal of documentation, follow up calls, and emails to the client and carrier
• Oversee the claims at the carriers to ensure timely investigation, liability determination, litigation and fair resolutions.
• Evaluate complex, high-exposure claims and interpret policy wording.
• Ability to work with demanding stakeholders, maintain client relationships, and be firm with carriers regarding policy coverage.
• Meet with clients when necessary and taking part in claim meetings, renewals and stewardship meetings
• Vital liaison between Client, insurance carrier, Defense Counsel and other vendors
• Partner and provide service to the internal Account Executive team and Producers re the service to the Client regarding claims, data analytics, providing education to the Client and cost containment initiatives.
• Perform Strategic Claim Reviews working in turn with Loss Control and Analytics
• Review claim trending and address any opportunities with the Client for Loss control initiatives.
• Counsel Clients on cost containment initiatives to reduce total claims, loss ratios, financials, timely file closure rates as well as timely reporting days.

Successful Candidate Will Have

• Valid P&C Brokers’ license or adjuster license – Multi State
• Minimum of 7-10 years of experience as a specialist in dedicated industry
• Must possess advanced knowledge of Property & Casualty coverages to include Healthcare Medical Professional Liability, Professional and General Liability for Healthcare systems and Cyber Liability.
• Familiarity with Claims Made and Occurrence policy forms with reporting protocols for Healthcare clients.
• Extensive knowledge of multi-line coverage and how coverage applies in the Healthcare industry
• Demonstrate proficiency in computer applications, esp. Microsoft Office Suite
• Possess the ability to provide superior customer service to both external and internal clients.
• Possess excellent client advocacy and negotiation skills
• Ability to perform strategic claim review
• Expertise in business practice area(s)
• Possess claim management/consultative skills

Risk Strategies is the 9th largest privately held U.S. brokerage firm offering comprehensive risk management advice, insurance and reinsurance placement for property & casualty, employee benefits, private client services, as well as consulting services and financial & wealth solutions. With more than 30 specialty practices, Risk Strategies serves commercial companies, nonprofits, public entities, and individuals, and has access to all major insurance markets. Risk Strategies has over 200 offices and more than 5,400 employees as part of the Accession Risk Management Group family of companies.

Industry recognition includes being certified a Great Place to Work in 2023 and on the Inc. 5000 list as one of America's fastest growing private companies. Risk Strategies is committed to being good stewards for our company, culture, and communities by having a strong focus on Environmental, Social, and Governance issues.

Pay Range:

$110,000 - $150,000 Annual

The pay range provided above is made in good faith and based on our lowest and highest annual salary or hourly rate paid for the role and takes into account years of experience required, geography, and/or budget for this role.

Brown & Brown, Inc. and our team of companies is an equal opportunity workplace and is committed to ensuring equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, Veteran status, or other legally protected characteristics. Learn more about working at Risk Strategies, part of the Brown & Brown team, by visiting https://us.bbrown.com/careers/.

Personal information submitted by California applicants in response to a job posting is subject to Risk Strategies' California Job Applicant Privacy Notice.

Originally posted on Himalayas