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Claims Attorney / Sr. Claims Specialist

Summary

Are you a detail-oriented, organized, dependable team player with solid communication and people skills looking for an opportunity to contribute to our growing organization’s success? If so, we want to talk to you!

Preferred Physicians Medical (PPM) is a national medical professional liability insurance provider, and an insurance industry innovator in providing anesthesia-specific insurance, patient safety and risk management strategies.

Our Claims Attorney / Sr. Claims Specialist position is a significant opportunity for the right individual. Successful candidates will become an important contributor to the entire organization’s achievements.

We need a professional to handle low to moderate severity medical malpractice claims, including the following:

  • Receiving reports directly from physicians via telephone and mail, documenting the initial report and collecting necessary information
  • Verification of insurance coverage
  • Conducting initial investigations by collecting narrative statements, medical records, medical reviews and analyzing the Company’s exposure
  • Attending regular departmental meetings to provide updates and report on strategy
  • Making reserve recommendations
  • Assigning cases to local defense counsel
  • Directly or through supervision of defense counsel, monitoring all cases and undertaking file management responsibilities
  • Directly or through the exchange of information with defense counsel, developing an appropriate defense strategy
  • Maintaining expert witness data and assisting defense counsel with selection of experts
  • Attending trials, mediations and settlement conferences as required, and negotiating settlements in accordance with instructions and authority extended by management
  • Initiating and maintaining ongoing reports to reinsurers as required
  • Monitoring and controlling case file loss adjustment expenses, audits appropriateness of billed expenses, and approving payments in accordance with Company policies and procedures
  • Complying with all National Data Bank and state regulatory agency reporting requirements
  • Providing guidance, advice and risk management to insureds as appropriate and requested, including live risk management presentations to insureds, medical societies and other organizations

Skills Required:

  • Ability to manage multiple cases and priorities simultaneously and meet deadlines
  • Ability to define problems, collect data, establish facts and draw valid conclusions
  • Ability to perform legal analysis of complex medical malpractice cases, including medical/legal issues, jurisdictional and procedural matters, defense, settlements and trial strategies, as well as the ability to coordinate same with outside counsel
  • Ability to organize with attention to detail
  • Computer expertise using various software packages, including Microsoft Word and Outlook
  • Excellent writing, presentation and people skills

Education and/or Experience Required:

Bachelor's degree (B. A.) from four (4) year college or university and four (4) years of related experience and/or training; or Juris Doctorate degree (J. D.); or equivalent combination of education and experience.

In all states where the Company is registered to do business, the following licensing and regulatory requirements must be met:

  1. Within six months of hiring, requires an insurance property and casualty independent adjuster license in a designated home state.
  2. Within one year of hiring, fulfillment of all other insurance property and casualty independent adjuster requirements (including additional licensing where necessary). Exceptions will be made in States where the individual is not yet qualified; however, once qualified, requirements must be met.

Such licensing and requirements must be maintained and current throughout employment.

PPM provides a competitive salary and excellent benefits.

If you are interested and would like to pursue this great opportunity with a successful company, apply now at Online Application.