Specific duties include but not limited to the below:Investigate, evaluate and resolve Healthcare claims, including claims involving long-term care, dental, and individual physicians. Develop and implement a strategy to resolve matters of liability and damages of a particular case. Analyze coverage, liability and damages for purposes of assessing and recommending reserves. Prepare and present written and oral reports to senior management setting forth all issues influencing evaluation and recomm... more details
With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility?.
Position Overview
Arch Insurance Group Inc., AIGI, has an opening with the Claims Division on the Healthcare Team as a Senior Claims Examiner .
Primary Responsibilities
Specific duties include but not limited to the below:
Investigate, evaluate and resolve Healthcare claims, including claims involving long-term care, dental, and individual physicians.
Develop and implement a strategy to resolve matters of liability and damages of a particular case
Analyze coverage, liability and damages for purposes of assessing and recommending reserves
Prepare and present written and oral reports to senior management setting forth all issues influencing evaluation and recommending reserves
Manage excess accounts and perform audits
Identify and assess coverage issues and draft coverage position letters
Maintain contact with the insured, underwriter, primary adjuster, counsel retained by primary carrier and the broker
Make decisions whether to retain monitoring counsel, request tender of defense from primary or proceed with the litigation utilizing counsel retained by the primary
Retain counsel when necessary and direct counsel in accordance with resolution strategy
Attend mediations, trials, and other proceedings relevant to the resolution of the matter
Travel to and from such locations within the United States
Select and utilize structure brokers
Process invoice and indemnity payments
Qualifications
Bachelor’s degree; Juris Doctorate degree preferred
Five (5) years of working experience supporting commercial accounts for Healthcare claims including claims involving long term care, dental, and/or individual physicians
Proper & active adjuster licensing in all applicable states
Exceptional communication (written and verbal), evaluating, influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines
Strong time management and organizational skills
Ability to take part in active strategic discussions
Ability to work well independently and in a team environment
Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word
Willing and able to travel 10%
#LI-SW1
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For individuals assigned or hired to work in California, Colorado, Hawaii, Jersey City, NJ; New York State; and/or Washington State, the base salary range is listed below. This range is as of the time of posting. Position is incentive eligible.
107,900-145,000
Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above range may be modified in the future
Click here to learn more on available benefits
Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn’t the right fit but you’re interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch’s Talent Acquisition team.
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