Senior Complex Claims Specialist - Allied Healthcare

Job Type Permanent Build a brilliant future with Hiscox Our Senior Complex Claims Specialist - Allied Healthcare is an individual contributor role, responsible for the handling of mostly high-severity primary Allied Healthcare Professional Liability claims from inception to resolution. This includes, but is not limited to, mental health counseling practices, social services, medical spas, home health aid and healthcare staffing agencies, pharmacies and testing laboratories. The role is responsible for all aspects of the claims and litigation process, including liaising with external and internal business partners (e.g., outside experts and/or legal counsel; underwriting) as required. This Role Acts as subject matter expert within the teamModels gold standard for litigation best practices and file integrityIdentifies and provides potential solutions for emerging exposures and claims trendsIdentifies suspected fraudulent claims and tracks with special investigations unitWith minimal supervision, adjusts to resolution the highest severity claims and drafts the most complex technical coverage analysis and letters requiredUses superior knowledge and experience to affect positive claim outcome via investigation, negotiation and utilization of alternative dispute resolutions, including identifying appropriate matters for trialAccurately documents claim files with all relevant correspondence and notes in compliance The Team The US Claims team at Hiscox is a growing group of professionals working together to provide superior customer service and claims handling expertise. The claims staff are empowered to manage their claims within given authority to provide fair and fast resolution of claims for our insured and broker partners. With strong growth across the US business, the Claims team is focused on delivering profitability while reinforcing Hiscox’s strong brand built on a long history of outstanding claims handling. Requirements 10+ years of Professional Liability and/or Medical Malpractice liability handling experience.B.A./B.S Degree required, JD optimalJD from an ABA accredited law school may be considered as a supplement to claims handling experienceAdjuster licensing is required within 90 days of employmentProven ability to positively affect complex claims outcomes through investigation, negotiation and effectively leading litigationAbility to work in a fast-paced and changing environmentAdvanced knowledge of coverage within the team’s specialty or focusAdvanced knowledge of litigation process and negotiation skillsExperience in mentoring and training other claims examinersExcellent verbal and written communication skillsAdvanced analytical skillsProven ability to positively affect highest severity claims outcomes through investigation, negotiation and effectively leading litigation and managing defense counsel and claim strategy. Additional Factors To Consider Subject matter expertise or technical leadership in other lines of business and/or claim typesDemonstrates ability to work with minimal oversightDemonstrates ability to advance product innovation or develop a greater understanding of other aspects of the business through training or other relevant projects across teams of lines of businessDemonstrates courage and confidence in addressing and solving difficult or severity matters with insureds, attorneys, and brokers What Hiscox USA Offers Competitive salary and bonus (based on personal & company performance) 401(k) with competitive company matching Comprehensive health insurance, vision, dental and FSA plans (medical, limited purpose, and dependent care) Company paid group term life, short- term disability and long-term disability coverage 24 Paid time off days, 2 Hiscox Days, 10 paid holidays, and ability to purchase 5 PTO daysPaid parental leave 4 week paid sabbatical after every 5 years of service Financial Adoption Assistance and Medical Travel Reimbursement ProgramsAnnual reimbursement up to $600 for health club membership or fees associated with any fitness programRecipient of 2024 Cigna’s Well-Being Award for having a best-in-class health and wellness programDynamic, creative and values-driven cultureModern and open office spaces, complimentary drinks Salary Range: $140,000-$170,000 The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. Please note that this position is hybrid and requires two (2) days in our office weekly** About Hiscox USA Hiscox USA was established in 2006 to focus primarily on the needs of small and middle market commercial clients, via both the broker and direct distribution channels and is today the fastest-growing business unit within the Hiscox Group. Hiscox USA offers a broad portfolio of commercial products, including technology, cyber & data risk, multiple professional liability lines, media, entertainment, management liability, crime, kidnap & ransom, commercial property and terrorism. Work with amazing people and be part of a unique culture