Complex Claims Specialist, Miscellaneous Medical Facilities Professional Liability
Core
Own and manage Long-Term Care (LTC) Professional Liability claims from first notice through resolution, including investigation, coverage analysis, reserve setting, and litigation management.
Role type
Senior Claims Specialist (Professional Liability)
Builds
Resolved claims and settlements for LTC professional liability policies
Domain
Insurance / Healthcare Liability
Required skills
LTC professional liability claims management, advanced coverage analysis, reserve setting, litigation management, defense counsel supervision, regulatory compliance, clinical knowledge (falls, pressure injuries, medication errors), negotiation, trend analysis
Preferred skills
Advanced degree, experience with high-severity or multi-claimant matters
Technologies
Claims Management System
Responsibilities
Investigate and analyze coverage for LTC claims, establish and adjust indemnity and expense reserves, manage litigation including counsel selection and budget control, coordinate clinical experts for chart review, interface with regulatory teams, report claim trends to management, participate in mediations and arbitrations
Seniority
Senior, hands-on IC