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 to direct 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)

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

Benefits

We are proud to offer our employees, their domestic partners, and their children, a wide range of insurance benefits:

• Two options for your 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.
• Safety and health programs that enhance your physical and mental well-being.
• 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.

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. In addition, the company makes available a variety of benefits to employees, including health insurance coverage, an employee wellness program, life and disability insurance, 401k match, retirement savings plan, paid holidays and paid time off (PTO).