Senior Claims Examiner, Healthcare

Position Summary

The Claims Division is seeking a highly experienced professional to join the Healthcare Claims Team as a Senior Claims Examiner. In this role, the examiner will be responsible for actively managing and effectively overseeing an assigned caseload of complex healthcare-related claims for hospitals, miscellaneous healthcare facilities and other healthcare providers.

Responsibilities

• Identify and assess coverage issues, draft coverage position letters, and retain coverage counsel, when necessary as well as review coverage counsel's opinion letters and analysis
• Develop and implement strategy relative to coverage issues which correlate with the overall strategy of matters entrusted to the handler's care
• Develop and implement strategy to resolve matters of liability and damages of a particular case
• Maintain contact with the claim staff, business line leaders, underwriters, defense counsel, and brokers
• Investigate claim and review the insureds' materials, pleadings, and other relevant documents
• Identify and review of each jurisdiction's applicable statutes, rules, and case law
• Review litigation materials including depositions and expert's reports
• Analyze and direct risk transfer, additional insured issues, and contractual indemnity issues
• Retain counsel when necessary and direct counsel in accordance with resolution strategy
• Analyze coverage, liability and damages for purposes of assessing and recommending reserves
• Prepare and present written/oral reports to senior management setting forth all issues influencing evaluation and recommending reserves
• Negotiate resolution of claims
• Review and evaluate defense counsel invoices for reasonableness and process associated payments
• Maintain a diary of all claims, post reserves in a timely fashion, and expeditiously respond to claims inquiries from insured, counsel, underwriters, brokers, and senior management
• Travel to and from locations within the United States to attend mediations, trials, and other proceedings relevant to the resolution of the matter

Experience & Required Skills

• 5-7 years of work experience handling management liability claims process at a carrier, broker, or law firm
• Exceptional communication (written and verbal), evaluation, influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines
• Strong time management and organizational skills
• Ability to take part in active strategic discussions
• Ability to work well independently and in a team environment
• Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word
• Willing and able to travel 15-20%

Education

• Bachelor’s degree required; Juris Doctorate degree preferred
• Proper adjuster licensing in all applicable states preferred

Pay

• For NY, NJ: $123,400 - $191,628/year
• For IL: $111,100 - $172,465/year

Benefits

• Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs.
• Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more.