In-House

Atlanta, GA, United States

Attorney in Atlanta, GA

Non-practicing Attorney

Min 10 yrs required

No

Claims Advisor, Professional Liability
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locations
US Telecommuter

posted on
Posted 30+ Days Ago

job requisition id
R55002

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Claims Advisor, Professional Liability

To analyze complex or technically difficult management, executive, cyber, public entity, errors and omissions, and professional liability claims; to provide resolution of said type of highly complex claims; to coordinate case management within company standards, industry best practices and specific client service requirements; and to manage the total claim costs while providing high levels of customer service.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

Analyzes and processes complex or technically difficult liability claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions.
Negotiates claim settlement up to designated authority level.
Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life.
Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement.
Performs coverage analysis and opinion as part of the claim process including all necessary correspondence.
Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines.
Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients.
Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost.
Represents company in depositions, mediations, and trial monitoring as needed.
Communicates claim activity and processing with the client; maintains professional client relationships.
Ensures claim files are properly documented and claims coding is correct.
Refers cases as appropriate to supervisor and management.
Delegates work and mentors others.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

Performs other duties as assigned.
Travels as required.

QUALIFICATIONS

Education & Licensing

Masters or Juris Doctorate degree from an accredited college or university preferred. Licenses as required. Designations and/or licensing including but not limited to Bachelor of Science in Nursing, Legal Nurse Consultant, Associate in Claims (AIC), Chartered Property and Casualty Underwriter (CPCU), Associate in Risk Management (ARM), Associate in Insurance Claims (AIC), Certified Professional in Health Care Risk Management (CPHRM) preferred.

Experience
Ten (10) years of complex claims management experience or equivalent combination of education and experience required.

Skills & Knowledge

In-depth knowledge of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim duration, cost containment principles
Extensive knowledge and comprehension of insurance coverage
Claims expertise in errors and omissions, directors and officers, public entity, and/or cyber liability
Excellent oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Analytical and interpretive skills
Strong organizational skills
Excellent negotiation skills
Good interpersonal skills
Ability to work in a team environment
Ability to meet or exceed Performance Competencies

WORK ENVIRONMENT
When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical: Computer keyboarding, travel as required

Auditory/Visual: Hearing, vision and talking

NOTE: Credit security clearance, confirmed via a background credit check, is required for this position.

As required by law, **MEMBERS ONLY**SIGN UP NOW***. provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $110,000. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

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