- Collect medical records and other investigation materials in a timely manner.
- Interview clients (in person, when possible) and claimants
- Work with plaintiff and defense attorneys, research case issues, and arranges expert reviews.
- Evaluate claims by considering coverage, liability exposure, causation/damages, and sources of contribution.
- Complete time sensitive reserve reports using established reserving procedures.
- Communicate investigation results and recommendations to clients.
- Consult with defense counsel regarding legal issues and case assessments.
- Document all casefile activity in claims system including saving documents
- Routinely documents a Plan of Action (POA) that shows active casefile management.
- Obtain client's consent to settle, with discussion regarding settlement process, and reporting.
- Determine the appropriate monetary values for settlement of claims.
- Handle negotiation process by obtaining all necessary settlement authority prior to initiating negotiations, determining negotiation strategy, and conducting negotiation and settlement claims.
- Resolve claims in a timely manner.
- Ensure regular and consistent communication with clients.
- Prepare closing and settlement documents, and complies with reporting requirements.
- Report cases to all internal and external reporting entities, including clients and their agents, co-defendants, reinsurers, claims committee, licensing boards and data banks.
- Maximize the successful outcome of cases in a cost-effective manner.
- Direct and actively manage defense counsel.
- Participate in assessment of counsel's performance.
- Oversee and monitor legal and general expenses.
- Ability to read and understand medical terminology and medical reports, legal documents and insurance coverage provisions.
- Strong investigation, evaluation and negotiation skills.
- Demonstrated strong verbal and written communication style
- 5+ years insurance/claims experience required.
- 5+ years professional/medical liability claims experience preferred.
- Bachelor's degree required.
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Claims Consultant - Hudson, United States - Constellation
Description
About UsCuri is a full-service advisory firm that serves physicians and medical practices. Equal parts fierce physician advocates, smart business leaders, and thoughtful partners, Curi's advisory, capital, and insurance offerings deliver valued advice that is grounded in client priorities and elevated by their outcomes. From data-driven advisory services to private wealth offerings, to tailored medical malpractice insurance solutions and beyond, we deliver performance that is time-tested and trusted-in medicine, business, and life.
The Role
We're looking for a focused and experienced individual to work in our Claims department as a Claims Consultant. Reporting to our Claims Team Lead, you will be responsible for managing cases from beginning to end using only best practices. You will work with our clients while also partnering with outside defense counsel. You will provide expertise in claims investigation & evaluation, claims negotiation & resolution, and manage the litigation process including the partnership with defense counsel.
Key Result Areas
Claims investigation & evaluation
