Senior Claim Specialist- Healthcare Liability- Correctional Medicine

Join our growing team of dedicated professionals at Gallagher Bassett, who guide those in need to the best possible outcomes for their health and wellbeing. You'll be part of a resilient team that works together to redefine the boundaries of excellence. At our organization, we value collaboration and making a positive impact in the lives of our clients and claimants, offering you the opportunity to join a team where your skills and dedication can truly make a difference.

GUIDE. GUARD. GO BEYOND.

We believe that every candidate brings something special to the table, including you! So, even if you feel that you’re close but not an exact match, we encourage you to apply.

Jurisdictions: Open to any

Licenses: must be willing to obtain all licenses stated by manager within specified timeframe

Location: This role is eligible for fully remote work.

Claims Background: Correctional Medicine

• Analyzes coverage and settles the most complex and challenging claims within Gallagher Bassett’s specialty claims areas (excluding workers' compensation).

• Handles the full life cycle of all assigned claims files, from intake to resolution.

• Determines coverage applicability and defense obligations independently.

• Conducts thorough investigations and analysis to assess exposure and develop settlement strategies and action plans.

• Drafts and issues reservation of rights and coverage denial letters.

• Negotiates settlements with clients, client attorneys, and Public Adjusters.

• Engages with all parties involved in the claims process; may recommend retaining outside experts when appropriate.

• Prepares reserve and settlement authority requests for both client and carrier approval.

• May act as a client advocate with carriers to ensure proper handling of claims, including scoping, estimating, and addressing coverage issues.

• Possesses solid understanding of claims processing and the insurance brokerage business.

• Demonstrates deep knowledge of industry-specific terminology, case law, and specialized claims areas.

• Handles claims in alignment with client and corporate policies, best practices, and all regulatory and ethical standards.

• Provides guidance and mentorship to junior adjusters.

• Capable of handling a full caseload independently and effectively.

Potential candidates should have the following:

• Claims Background:
  Correctional Medicine
• Jurisdictional Experience:
  Any
• Active Adjusters' licenses: must be willing to obtain all licenses stated by manager within specified timeframe

As a key member of our Claims Adjuster team, you will:

• Investigate, evaluate, and resolve complex Medical Malpractice claims, applying your claims experience and analytical skills to make informed decisions and bring claims to resolution.
• Work in partnership with our clients to deliver innovative solutions and improve the claims management process
• Think critically, solve problems, plan, and prioritize activities to optimally serve clients

REQUIRED QUALIFICATIONS:

• High school diploma.

• Minimum of 5+ years of experience handling claims within the applicable specialty area (Medical Malpractice).

• Proven ability to handle complex and challenging claims issues at a senior adjuster level.

• Licensed and/or certified in all applicable states, or able to acquire necessary licenses per local requirements.

• Familiarity with accepted industry standards and practices.

• Proficient with relevant claims management and business software.

DESIRED:

• Bachelor's Degree
• Law Degree
• 10+years of prior experience adjusting claims in applicable specialty area
• Experience in claims as well as the insurance legal and regulatory environment

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We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours.

On top of a competitive salary, great teams and exciting career…