Claims Examiner

Title - Clinical Risk ManagerOnsite - possible hybrid ideal candidate is localcontract to ends 3/31 with the option to extend

Legal Claims ManagerResponsibilities

" Work with risk managers, senior leaders, and external attorneys to review coverages, investigate claims, analyze liability and damages, establish adequate indemnity and expense reserves, develop strategies and resolve claims, including, but not limited to direct participation in mediation and arbitration and active participation in settlement discussions." Provide regular reports to risk management and senior leaders regarding losses either exceeding or likely to exceed the authority level in accordance with best practices. Must be able to present effectively, produce appropriate reports and develop team and train team in these skills" Partner with underwriting managers/team to provide excellent customer service and to market and meet with brokers, risk managers and reinsurers." Serve as external face claims leader for product line and demonstrate ability to forge and maintain relationships with external customers, effectively resolving concerns where necessary." Ability to effectively articulate the claims value proposition in claims advocacy meetings, account renewals and new business prospecting." Lead short to medium-term strategic claims activities/priorities" Oversee projects assigned by the department head." Direct and manage the claims participation and content for multidisciplinary reviews, monthly meetings, and quarterly actuarial or insurer meetings." Ensure timely feedback to senior management, underwriting and actuaries regarding relevant losses, account issues, and trends." Other duties as assigned, including delivery on established operational goals and objectives.

Qualifications

" Bachelors' degree or equivalent training; advanced degrees or certifications preferred." A minimum of 6-8+ years of relevant and progressively more responsible work experience required" At least 5 years claims handling within a technical specialty." Requires advanced knowledge of claims handling concepts, practices, procedures and techniques, including, but not limited to coverage issues, product lines, marketing, computers and product competition within the marketplace." Requires Medical-Legal understanding." Knowledge of law and insurance regulations in Colorado." The ability to effectively interact with brokers and internal departments." Strong verbal and written communications and organizational skills." Strong negotiation, analytical and decision-making skills also required.