Senior Claims Specialist - Health

About the role

The Senior Claims Specialist on the Healthcare team plays a critical role in our growing Claims Department and will be responsible for directing all aspects of file handling on both in-house and third-party administered claims, with growth opportunity in technical handling and professional development.

Responsibilities

• Thorough investigation and assessment of claims related to healthcare, damages, pursuit of recoveries and subrogation/contribution opportunities.
• Demonstrate an in-depth understanding of coverage issues, policy forms, contracts, regulatory requirements, and changing legal landscape for specialty line claims.
• Proactively and promptly manage claims, considering all aspects with a strategic vision for optimal claim outcome.
• Continually evaluate claims to set appropriate, timely reserves over the life of the claim to reflect changes in exposure.
• Demonstrate strong technical claims proficiency through consistent execution of best claim practices.
• Strategically coordinate and manage outside counsel and vendors to obtain optimal claim outcome.
• Present high exposure claims to Claims Leadership and Key Stakeholders.
• Collaborate with internal and external business partners for client meetings, product development and improvement, and account audits.
• Look for ways to improve claim efficiencies and outcomes (innovative mindset).

Requirements

• Successful candidates will possess the following experience/skills/qualifications:
• Bachelor’s degree required. Law degree preferred.
• 7 years plus experience in handling specialty claims.
• Experience in handling Life Sciences and/or Allied Health claims preferred.
• Detail-oriented, adaptable, and strategic in decision-making.
• Understanding of technical claims proficiency and execution of best claim practices.
• Ability to work independently, multi-task, and remain self-motivated in a fast-paced environment.
• Strong organizational skills and time management of claims desk.
• Strong business acumen and ability to collaborate with other departments and vendors.
• Customer-service and relationship oriented.
• Innovative, dynamic and growth mindset.
• Good verbal and writing skills for internal and external communication, presentations and reporting.
• Good analytical thinking, advocacy and negotiation skills.
• Willingness to travel for mediations, settlement conferences, and client or account meetings. (up to 25%).

Qualifications

• Maintain valid adjusters’ license(s) in states assigned or an ability to obtain same.

Benefits

• Health insurance plan (PPO or High Deductible).
• Prescription drug coverage (included in your health insurance plan).
• Vision and dental insurance plans.
• Additional insurance coverages provided at no cost to you, such as basic life insurance equal to 1x annual salary and AD&D coverage that is equal to 1x annual salary.
• Short and Long Term Disability coverage.
• Supplemental Life and AD&D plans that you can purchase for yourself and dependents (includes Spouse/domestic partner and children).
• Voluntary Benefit plans that supplement your health and life insurance plans (Accident, Critical Illness and Hospital Indemnity).

Schedule

The Company is open to considering candidates in numerous locations, including Philadelphia (PA), Chicago (IL), Atlanta (GA), Princeton (NJ), or Hartford (CT).

Pay

The base salary range anticipated for this position is $101,700 - $155,900, plus opportunity for company bonus based upon a percentage of eligible pay.

Benefits

• A robust 401k plan with up to a 5% employer match.
• A retirement savings plan that is 100% company funded.
• Paid time off that begins with 24 days each year, with more days added when you celebrate milestone service anniversaries.
• Eligibility to receive a yearly bonus as a Munich Re employee.
• A variety of health and wellness programs provided at no cost.
• Paid time off to volunteer in your community.
• Tuition assistance and educational achievement bonuses.
• A corporate matching gifts program that further enhances your charitable donation.