[Hiring] Claims Specialist - Healthcare Professional Liability @Gallagher

Role Description

The Claims Specialist within GB Specialty is responsible for managing moderately complex Healthcare Professional Liability claims. This role manages the full claim life cycle, including:

• Coverage analysis
• Investigation
• Evaluation
• Resolution

Ensures claims are handled in accordance with client expectations, policy obligations, and regulatory requirements.

How you'll make an impact:

• Analyzes coverage and settles moderately complex claims in Healthcare Professional Liability.
• Generally, does not work on workers’ compensation claims.
• Able to manage the full-life cycle of all assigned claims files.
• Analyzes coverage and determines defense obligations.
• Under minimal supervision, conducts thorough analysis and investigations necessary to determine claims exposure and recommend appropriate settlement strategies and action plans.
• Creates reservation of rights and coverage denial letters.
• Negotiates settlements with clients, client attorneys, and Public Adjusters.
• Interacts extensively with various parties involved in the claims process, and may recommend retaining the advice of outside experts as necessary.
• Prepares reserve and settlement authority requests for client and carrier approval.
• May act as a client advocate with carriers to ensure proper claims handling, including any necessary scoping, estimating, and addressing of coverage.
• Has a solid understanding of claims processing and the insurance brokerage business.
• Has a basic understanding of the terminology and case law associated with correctional medicine professional liability claims.
• Handles claims consistent with clients’ and corporate policies, procedures and best practices and in accordance with statutory, regulatory, and ethical requirements.
• Incumbents at this level should be able to work at full caseload capacity.

Qualifications

• Paralegal experience, junior professional liability claims experience, or insurance claims support background, preferably within healthcare or medical professional liability.
• Open to any jurisdictional experience.
• Not required initially; must be willing to obtain licenses as directed.

Requirements

• Bachelor's Degree Required.
• Minimum 2 years of experience in claims, insurance, paralegal, legal support, or a related environment.
• Strong insurance fundamentals and understanding of claims processes.
• Ability to analyze documentation, summarize facts, and support coverage and liability determinations.
• Computer proficiency with claims systems and standard business software.
• Must be able to obtain required adjuster licenses within designated timeframes.

Benefits

• Salary can be up to $120,000 per year, dependent upon experience.