VP,Claims Job Chicago area,Illinois USA,Insurance

Overview

Berkley Healthcare Medical Professional, a division of Berkley Healthcare, is seeking a highly accomplished, customer service-oriented claim professional to deliver superior claim results through execution of defined best practices while managing an inventory of high exposure and complexity healthcare professional liability claims.

Responsibilities

Investigate assigned claims through application of defined best practices. Actively develop information on reported claims, including specific facts of case, nature and extent of injury, standard of care and causation defenses, venue specific factors and other characteristics that impact claim severity.

Evaluate information obtained through claim investigations and estimate damage ranges for purposes of prompt identification of claims with potential excess exposure; apply ongoing triage rules to determine proper severity and assignment levels.

Directly manage and actively intervene on the most technically complex and highest severity claims within company inventory.

Timely recognize and evaluate claim exposures to establish accurate case reserves.

Execute effective claim adjudication strategies/tactics to help achieve optimal outcomes on exposures within and in excess of account retentions.

Cultivate strong business relationships with key personnel within current accounts, brokerage community, TPAs, and law firms within assigned territory.

Take lead claims role for on-site review process and support all account management needs of the company.

Aid in the development and modification of claim management practices, policies and procedures in furtherance of continuous process improvement culture.

Assist Underwriting and Actuarial in risk selection and pricing accuracy through claim due diligence for new and renewal business.

Utilize customer service skills with client contacts to advance business opportunities:

Identify service needs for claim, risk management and data mining strategy;

Understand renewal strategy;

Extend discussion with client beyond claim transaction and toward potential needs not immediately recognized by the decision maker.

Communicate effectively with team members.

Develop, or assist with development, of claims marketing content and utilization of content for marketing purposes.

Qualifications

Bachelor’s degree from four-year college or university; J.D. strongly preferred.
15 years of related experience handling healthcare professional liability claims with extensive experience in Chicago/Cook County and surrounding venues.
Experience servicing large healthcare accounts is strongly preferred.
Experience managing casualty claims in an excess environment is desirable.
Advanced knowledge of medical and legal terminology and concepts.
In-depth understanding of industry best practices for adjudicating casualty claims.
Proficiency with insurance contract interpretation and coverage issues.
Proficiency with Microsoft Office applications.
Willingness to travel up to 30% of the time.
Occasional evening and weekend work is required.

Additional Company Details

We do not accept any unsolicited resumes from external recruiting agencies or firms.

Benefits

The company offers a competitive compensation plan and robust benefits package for full time regular employees which for this role include:

Base Salary Range: $131,000– $243,000
Eligible to participate in annual discretionary bonus.
Benefits:
Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans.

The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.

Sponsorship Details

Sponsorship not Offered for this Role

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Job Posting Language

VP, Claims