TEST - Senior Claims Representative
Physicians Insurance A Mutual Company has been providing professional liability solutions to physicians, physician groups, and hospitals for more than four decades and is the largest insurer of physicians and rural critical-access hospitals in the Pacific Northwest. The company also provides excess, reinsurance, provider excess, health plan reinsurance and employer medical stop loss solutions. Insurance offerings are paired with risk management, claims, litigation peer support and legal defense services which embody the company’s commitment to providing the strongest possible protection for policyholders and rigorously defending the practice of quality medicine. Through Physicians Insurance Risk Retention Group LLC, Physicians Insurance is expanding its offerings strategically nationwide. Both Physicians Insurance and Physicians Insurance RRG are rated A- (Excellent) by A.M. Best.
This Senior Claims Representative is responsible for national medical malpractice claim services. This includes performing claims investigation, evaluation, negotiation, settlement; retaining and coordinating work of defense attorneys and expert witnesses; representing Experix and Physicians Insurance clients; and maintaining claims-related relationships with physicians, other insurance companies, and other organizations. This position will include national claims handling on behalf of Physicians Insurance and Physicians Insurance RRG through Physicians Insurance Management Services.
Responsibilities include but are not limited to the following:
- Reviewing claims report, medical records, strategizing, and developing investigation priorities and schedules while initiating and maintaining communications with physicians, administrators, attorneys, expert witnesses, and other insurance companies.
- Coordinating and performing claim investigations, negotiations, legal defense, and settlement activities. This includes handling incident reporting, reserving, research, and evaluation.
- Presenting claim investigations at Claims Committee meetings.
- Planning and implementing defense and litigation strategies. This includes pre-trial and trial preparations and attending meetings, depositions, and mediations via videoconferencing or in person as determined by location, needs of account, and/or Court requirements.
- Analyzing claims, defense counsel, settlements, and other results.
- Facilitating and developing relationships with defense counsel, consulting physicians, expert witnesses, co-defendants, other insurance companies, and legal defense specialists.
- A 4-year college degree or equivalent work experience
- State adjuster licensure
- Five plus years of professional medical liability claims experience with a history of increasing claims responsibility and authority
- Excellent analytical and detail-oriented skills
- Excellent investigation, research, and negotiation skills
- Demonstrated time management and prioritization skills
- Demonstrated knowledge of insurance policies and coverages
- Strong commitment to customer service, quality, and working in a collaborative team environment
- Excellent interpersonal, verbal, and written communication skills. Ability to present effectively to large or small groups.
- Demonstrated technical ability to work with Microsoft Office, ShareFile and Adobe Acrobat Pro
- Ability to travel in person as determined by location, needs of account, and/or Court requirements