Claims Specialist – Medical Malpractice
About the Role
A leading specialty insurance organization is seeking a Claims Specialist to join its North America Claims team. In this role, you will manage primary medmal liability claims, including highly complex matters requiring thorough investigation, coverage analysis, and strategic resolution. You’ll collaborate closely with internal partners, brokers, insureds, and external stakeholders to ensure exceptional service and high-quality claim outcomes.
Key Responsibilities
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Evaluate and manage complex healthcare liability claims, including coverage determination, liability assessment, and settlement valuation.
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Conduct thorough investigations and partner with legal and investigative resources on contentious or high-exposure matters.
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Lead initiatives aimed at improving claims handling efficiency, accuracy, and workflow optimization.
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Provide expert perspectives during cross-functional meetings and support claims handling best practices across the organization.
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Partner with litigation and vendor management teams to control expenses and manage defense strategies.
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Maintain active participation in professional associations and stay current on industry trends.
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Communicate proactively with internal and external stakeholders to ensure transparency and service excellence.
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Mentor peers, support skill development, and contribute to training material development.
About You
We welcome diverse experience and recognize that each candidate brings unique strengths. Ideal candidates will demonstrate:
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Subject matter expertise in healthcare-related claims.
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Strong networking and relationship-building skills within the claims community.
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Proven leadership in process improvement initiatives.
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Ability to offer expert insights in collaborative and cross-functional settings.
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Experience developing or guiding training materials focused on claims best practices.
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Commitment to continuous professional development and staying current with regulatory requirements.
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Ability to review, refine, and uphold compliance within claims processes.
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A natural inclination to mentor others and support professional growth within the team.
Role Requirements
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Hybrid schedule: in-office 3 days per week.
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Ability to obtain and maintain required claims licensing.
Compensation & Benefits
Compensation reflects factors such as experience and location. The total rewards package includes:
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Competitive base salary and performance-based incentive opportunities
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Comprehensive health benefits for employees and families
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Wellness programs
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Retirement savings plans
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Tuition reimbursement
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Paid time off and additional employee benefits
Work Environment
This role is part of a performance-driven organization that values humility, collaboration, and continuous improvement. Team members demonstrate purposeful action, data-driven decision-making, and a commitment to achieving results together. The culture emphasizes integrity, mutual respect, and creating an environment where employees can bring their full selves to work.
Equal Opportunity
All qualified applicants will receive consideration for employment without regard to any legally protected characteristics. Accommodations are available upon request for candidates participating in the selection process.
