Senior Claims Representative

Position Overview

We are seeking a Senior Claims Representative to manage a caseload of complex medical professional liability claims and support the overall operations of the Claims Department.

The primary responsibilities include investigating, evaluating, and resolving claims brought against insured healthcare professionals. This individual will handle claims involving varied medical specialties and some of the department’s most severe and complex matters.

The Senior Claims Representative will also work closely with the Underwriting, Risk Management, Finance, and Business Development departments and will report directly to the Vice President of Claims.

Responsibilities

Claims Handling

• Identify and analyze coverage issues.
• Select and manage defense counsel.
• Coordinate initial consultations with insureds and defense counsel.
• Retain and consult with medical defense experts.
• Review and analyze medical records.
• Manage litigation, including maintaining communication with defense counsel, monitoring legal status reports, and reviewing legal billing practices.
• Attend depositions, court conferences, mediations, and trials.
• Maintain accurate internal documentation and report significant claim developments.
• Prepare claim status reports for reinsurers.
• Communicate regularly with insureds from the initial meeting through claim resolution.
• Develop and execute claim resolution strategies.
• Directly handle settlement negotiations with plaintiffs or their counsel.

General Responsibilities

• Maintain current knowledge of relevant legal decisions, claim trends, and industry practices.
• Use technology to improve productivity and claim outcomes.
• Collaborate with Claims team members and other departments.
• Manage an active and diverse caseload while meeting established deadlines.

Operational Support

• Assist with compiling and analyzing claims data.
• Periodically attend loss prevention, business development, and other professional events.
• Provide feedback on and support the implementation of organizational initiatives and technology projects.
• Inform the Underwriting Department of claim developments that may have underwriting implications.

Qualifications

• Bachelor’s degree in a relevant field.
• At least five years of casualty insurance claims handling experience, preferably involving complex claims or litigation.
• Two to three years of medical professional liability claims experience preferred.
• Experience handling claims in Connecticut and/or Massachusetts is preferred.
• Ability and willingness to travel frequently.
• Reliable transportation.
• Proficiency with Microsoft Office.
• Ability to meet deadlines while managing an active and diverse caseload.
• Strong written, verbal, and interpersonal communication skills.
• Ability to work outside the office when attending depositions, insured meetings, court conferences, mediations, and trials.
• Claims adjuster license in applicable states or willingness to obtain the required licenses after hire.

Location

The position may be based in Glastonbury, Connecticut, or Jacksonville, Florida.

Benefits

Benefits may include:

• Medical, dental, and vision insurance
• Employee Assistance Program
• Competitive salary
• Incentive bonus plan
• 401(k) with company match
• Group life insurance
• Short-term and long-term disability coverage
• Health Savings Account
• Educational assistance
• Biweekly automobile allowance
• Paid time off
• Company holidays
• Volunteer time off
• Charitable giving opportunities
• Team-building events
• Employee recognition programs

Equal Employment Opportunity

The employer provides equal employment opportunities to all employees and applicants and prohibits discrimination or harassment based on race, color, religion, age, sex, national origin, disability, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local law.