CHG Healthcare
People matter. Especially here.
Senior Medical Claims Adjuster
Location
Utah
Posted
35 days ago
Salary
$92.9K - $179.7K / year
Bachelor Degree5 yrs expEnglish
Job Description
• Responsible for managing medical professional liability claims.
• Managing data concerning medical professional liability claims within a database.
• Interacting with medical providers.
• Managing external counsel.
• Traveling (when necessary) to attend mediations, depositions, and trials.
• Negotiating and settling medical professional liability claims and lawsuits within established settlement authority.
• Document disciplinary actions, incidents, claims, and lawsuits concerning medical professional liability.
• Determine whether a covered claim has been made under the terms and conditions of a relevant policy of insurance and maintain a working knowledge of insurance policy forms to verify coverage.
• Establish, monitor, and authorize changes to indemnity and expense reserves on assigned claim files.
• Assign claim files to and supervise outside defense counsel, adjusters, and investigators and/or monitor medical professional liability claims being handled by an insurance company under an insured program.
• Evaluate liability and exposure in assigned claim files.
• Establish and proactively manage appropriate claim resolution, including formation and implementation of resolution strategy.
• Identify responsive documents and witnesses to properly evaluate incidents, claims, and lawsuits.
• Participate in periodic claim reviews with leadership.
• Independently manage incidents, claims, and lawsuits, including attending mediations and trials as necessary.
• Provide updates and recommendations on strategy for resolving incidents, claims and lawsuits to Sr. Leadership.
• Maintaining professional standards, conducting difficult conversations constructively, and modeling ethical conduct.
• Experience in building trust through transparency, ethical decision-making, and consistent leadership.
• Mentoring team development and fostering a positive culture.
• Ability to provide feedback, leadership presence, and relationship-building capabilities.
Job Requirements
- 5+ years of medical professional liability management experience.
- Multi-state experience adjusting medical professional liability claims.
- Willingness and ability to travel (nationally).
- Demonstrated track record of building high-performing teams through establishing trust, maintaining professional standards, and developing talent.
- Experience managing difficult conversations, providing corrective feedback, and addressing performance issues in a constructive and professional manner.
- Familiarity with claims management systems (preferably Assure Claims).
- Working knowledge of Microsoft Excel (pivot tables, lookups, indexes, etc.).
- Sound understanding of claim reserving process and loss runs.
- Strong interpersonal and communication skills with demonstrated ability to build trust and credibility with team members, providers, counsel, and leadership.
- Proven ability to provide constructive feedback and coaching in a professional, supportive manner that promotes growth and accountability.
- Leadership presence and sound judgment in managing sensitive personnel matters and maintaining confidentiality.
- Ability to develop and maintain productive working relationships based on mutual respect, transparency, and ethical conduct.
Benefits
- 401(k) retirement plan with company match
- Traditional healthcare benefits such as medical and dental coverage, and some unique benefits like onsite health centers, corporate wellness programs, and free behavioral health appointments.
- Flexible work schedules - including work-from-home options available
- Recognition programs with rewards including trips, cash, and paid time off
- Family-friendly benefits including paid parental leave, fertility coverage, adoption assistance, and marriage counseling
- Tailored training resources including free LinkedIn learning courses
- Volunteer time off and employee-driven matching grants
- Tuition reimbursement programs