Claims Specialist III
Location: Remote (U.S.)
Pay Rate: $55.00/hour
About the Opportunity
We are seeking an experienced Claims Specialist III to manage a portfolio of professional liability and medical malpractice claims in a fully remote environment. This role requires a strong claims professional who can independently investigate, evaluate, negotiate, and resolve complex claims while providing exceptional service to insureds, claimants, and business partners.
Key Responsibilities
- Manage moderate to high-exposure professional liability and medical malpractice claims from initial notice through resolution.
- Review policy coverage, assess liability, establish reserves, and develop claim resolution strategies.
- Conduct investigations by gathering statements, reviewing documentation, and collaborating with experts and legal counsel.
- Negotiate settlements and authorize claim payments within designated authority limits.
- Maintain accurate claim documentation and ensure compliance with company and regulatory guidelines.
- Partner with internal and external stakeholders to drive timely, quality claim outcomes.
- Identify potential fraud, recovery, and subrogation opportunities as appropriate.
- Provide mentorship and guidance to less experienced claim professionals when needed.
Required Qualifications
- Bachelor’s degree or equivalent combination of education and experience.
- Minimum 4 years of claims handling experience.
- Strong understanding of commercial insurance, policy interpretation, coverage analysis, and claim practices.
- Demonstrated investigative, analytical, and critical thinking skills.
- Experience negotiating claim settlements.
- Excellent verbal and written communication skills.
- Strong organizational skills with the ability to manage a high-volume workload.
- Proficiency with Microsoft Office and business applications.
- Ability to obtain and maintain an Insurance Adjuster License if required.
Preferred Qualifications
- Medical malpractice and/or professional liability claims experience.
- Experience independently managing a large volume of claims.
- CPCU or other insurance industry designations.
Benefits
- Fully remote work environment
- Competitive hourly compensation
- Opportunity for contract extension based on business needs
- Exposure to complex and high-impact claim matters
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