Claims Analyst, Med Psych, North American Claims Group (Finance)

Job Summary:

Investigate, evaluate, and resolve claims made against the Company's behavioral health and psychiatry program business including psychiatrists, psychologists and other behavioral health care providers liability.  Engage in collaborative projects in support of other areas of the company, including underwriting, finance and accounting, actuarial, operations, and technology.  Provide superior service to all customers, whether internal or external.

 

Job Duties:

·       Efficiently manage a vigorous caseload of claims. Promptly investigate matters, analyze coverage, draft accurate and timely coverage correspondence.  Manage litigation by effectively interacting with insureds, brokers, defense counsel and other parties as required.

·       Instruct and collaborate with counsel regarding litigation strategy and claim resolution; resolve claims; and otherwise act within the scope of delegated authority.

·       Approve reserves, payments and other actions consistent with authority.

·       Interact with underwriters concerning renewals and prospective accounts as well as individual claims and policy issues.

·       Work with other areas of the Company including underwriting, finance and accounting, actuarial, operations and technology on projects as required. 

·       Prepare claim summaries and other reports as necessary for management.

·       Attend and/or present at relevant industry conferences/meetings.

·       Assist with claims related queries in internal and external audits. 

Work with reinsurers as needed.

Job Requirements:

·     A minimum of two to five years' experience handling professional liability insurance claims or related relevant experience. Four-year college degree is required. J.D. degree or experience in handling medical malpractice or behavioral health claims is preferred.

·     Substantial knowledge of issues underlying claims and coverage issues. Excellent negotiation and communication skills. Technical writing experience.  Proficient in Microsoft Office products.