CHG Healthcare

People matter. Especially here.

Senior Medical Claims Adjuster

Full TimeRemoteTeam 1,001-5,000Since 1984H1B SponsorCompany SiteLinkedIn

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

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