Claims Specialist
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Job Location:
Los Angeles, CA - USA
Monthly Salary:
Not Disclosed
Posted on:
30+ days ago
Vacancies:
1 Vacancy
Job Summary
Job Summary (Claims Specialist - Orange County)
- Manage medical malpractice claims with increasing complexity and financial exposure
- Direct and oversee defense counsel activities in accordance with company guidelines
- Investigate and evaluate claims including reviewing medical records and interviewing relevant parties
- Prepare and present case evaluation reports for internal committees and management
- Oversee and participate in litigation activities such as discovery mediation settlement conferences and negotiation
- Monitor trials and arbitrations providing support and updates to members and defense attorneys
- Maintain accurate and timely documentation of case developments in claims systems
- Ensure all relevant information and documents are coded and indexed appropriately
- Assist management with special projects and coverage investigations
- Respond to hotline calls and prepare related documentation as needed
- Attend staff and department meetings as required
- Support and help train junior Claims Specialists (I and II)
- Perform additional duties as assigned by management
- Requires a bachelors degree relevant legal/medical background and minimum five years experience in medical malpractice claims management
- Must have a valid California drivers license
- Strong verbal/written communication analytical and time management skills required
- Ability to handle multiple priorities and deadlines; PC literacy preferred
- Manage medical malpractice claims with increasing complexity and financial exposure
- Direct and oversee defense counsel activities in accordance with company guidelines
- Investigate and evaluate claims including reviewing medical records and interviewing relevant parties
- Prepare and present case evaluation reports for internal committees and management
- Oversee and participate in litigation activities such as discovery mediation settlement conferences and negotiation
- Monitor trials and arbitrations providing support and updates to members and defense attorneys
- Maintain accurate and timely documentation of case developments in claims systems
- Ensure all relevant information and documents are coded and indexed appropriately
- Assist management with special projects and coverage investigations
- Respond to hotline calls and prepare related documentation as needed
- Attend staff and department meetings as required
- Support and help train junior Claims Specialists (I and II)
- Perform additional duties as assigned by management
- Requires a bachelors degree relevant legal/medical background and minimum five years experience in medical malpractice claims management
- Must have a valid California drivers license
- Strong verbal/written communication analytical and time management skills required
- Ability to handle multiple priorities and deadlines; PC literacy preferred
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