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Intercare Holdings Insurance Services · 3 months ago

Liability Claims Adjuster III

United States

Full-time

Remote

Senior Level

7+ years exp

Intercare Holdings Insurance Services is a dynamic third-party administrator specializing in claims and managed care solutions. They are seeking a Liability Claims Adjuster III to manage complex medical professional and general liability claims, ensuring compliance with regulations and fostering strong client relationships.

Health CareInsuranceRisk ManagementService Industry

Growth Opportunities

Responsibilities

Maintain a culture of positivity, respect, supportiveness, collaboration, patience, accountability and excellence

Assist with team building ideas and events

Lead by example and through service

Develop and maintain strong and collaborative client relationships

Establish prompt contact on all new losses within 24 hours of receipt of the claim, including the insured, claimant, or claimant representative, to document relevant facts surrounding the incident and obtain information relevant to analysis of liability and damages

Thoroughly and accurately evaluate coverage on a timely basis, document coverage analysis, identify coverage issues and draft appropriate coverage letters

Thoroughly and accurately investigate all claims and document ongoing case facts and relevant information necessary for establishing liability and damages. Perform and document ongoing analysis and evaluation and what is being done to move the case toward closure

Litigation management – Direct, manage and control the litigation process for nationwide programs

Assure that all assigned claims are maintained on an active 30–45-day diary and have an up-to-date plan of action outlining activities and actions anticipated for ultimately resolving the claim

Obtain consultant and/or expert reviews for early evaluation

Aggressively pursue contribution on multiple defendant cases or where provided by employment or independent contractor agreements and apportionment when there is shared liability

Assure that the claim file is handled in accordance with applicable statutes, in-force service contracts and company guidelines

Establish, monitor and adjust claim reserves in strict accordance with assigned authority levels and client claim-handling instructions

Exhibit and maintain a courteous and helpful attitude and project a professional image on behalf of the company and client

Respond to telephone messages and inquiries within 24 hours of receipt and to written inquiries within one week of receipt

Travel for mediations, trials, client meetings and/or industry-related conferences

Requires a working knowledge of medical terminology and various jurisdictional issues

Handle other duties and tasks as deemed appropriate by the Supervisor or Manager

Qualification

Claims handling expertiseMedical professional liabilityJDRN licensureRMIS softwareCommunication skillsCustomer serviceLeadership by exampleBusiness acumenProject management skillsProblem-solving skills

Required

Bachelor's degree from a four-year college or university

At least seven years of related experience and/or training

High degree of claims handling expertise, including at least five years managing medical professional liability cases, many with complex litigation or high potential value

Ability to read, analyze and interpret insurance policies, statutes, legal opinions, business periodicals, professional journals, technical procedures and governmental regulations

Ability to write complex coverage letters, reports, business correspondence, procedure manuals and correspondence to clients, colleagues and industry peers

Ability to effectively present information verbally and in writing and respond to questions from groups of managers, clients, customers and the general public

Fluent spoken and written English

Ability to add, subtract, multiply and divide in all units of measure using whole numbers, common fractions and decimals

Ability to compute rate, ratio and percent and to draw and interpret bar graphs

Strong problem-solving and analytical skills

Ability to apply common-sense understanding to carry out instructions in written, oral or diagram form

Ability to deal with problems involving several concrete variables in standardized situations

Proficiency in Word, Excel, Outlook, PowerPoint, RMIS software, RingCentral, Zoom, TEAMS, WebEx, GoToMeeting and other tele-video conferencing software and apps

Appropriate jurisdictional adjuster license required