Claims Specialist - Aging Services Medical Malpractice
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POST DATE 9/14/2016
END DATE 10/18/2016
JOB DESCRIPTIONIndividual contributor responsible for the overall investigation and management of litigated and non-litigated Aging Services claims in multiple jurisdictions. Duties will include investigation of claims, and direction and supervision of defense counsel. Individual, under general management direction, will work within specific limits of authority on assignments requiring significant technical complexity and coordination. Individual should be able to utilize claims policies and guidelines, review, analyze and address coverage issues, determine liability and damages, secure information and negotiate and settle claims to appropriate resolution.
Essential Duties & Responsibilities
1. Manage investigation of claims, including interpretation and analysis of policy coverages and determines if coverages apply to claims submitted, escalating issues as needed.
2. Sets reserves and authorizes payment within scope of authority, effectively resolving claims in the most cost effective manner and ensuring timely issuance of payments.
3. Coordinates and performs investigations and evaluates claims and suits through contact with insureds, claimants, witnesses and experts.
4. Utilizes negotiation skills to develop settlement packages.
5. Identifies claims with third party recovery potential.
6. Works with attorneys, account representatives, agents, medical providers and insureds regarding the handling and/or disposition of more complex claims.
7. Analyzes claims activities and prepares reports to management and other internal business partners and clients. 8. Update and utilize claims systems appropriately.
9. May provide guidance and assistance to other claims staff and functional areas.
10. Keeps current on state/territory regulations issues as well as industry activity and trends.
SKILLS, KNOWLEDGE & ABILITIES
1. Solid knowledge of claims and insurance industry theory and practices.
2. Demonstrated technical expertise and product specific knowledge.
3. Strong interpersonal, written and oral communication and negotiation skills. Must have the ability to effectively interact with all levels of CNA's internal and external business partners.
4. Ability to work independently.
5. Strong analytical and problem solving skills.
6. Ability to exercise independent judgment and make critical business decisions effectively.
7. Knowledge of Microsoft Office Suite as well as other business-related software.
EDUCATION & EXPERIENCE
1. Bachelors degree or equivalent experience. Professional designation preferred
2. Typically a minimum three to five years claims experience
3. Multi-jurisdictional experience/multi-state licenses preferred
Primary Location: United States-Illinois-Chicago
Other Locations: United States-Illinois-Chicago
Organization: CLAIM USSPL (US Spec Lines)
Job Posting: Sep 13, 2016
Unposting Date: Ongoing.
We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.