CNA Insurance
Complex Claims Consultant - Dental Healthcare
CNA Insurance, Chicago, Illinois, United States, 60290
Overview
Complex Claims Consultant - Dental Healthcare at CNA Insurance. The role supports the Healthcare business, interacting with insureds, attorneys, other insurers and account representatives regarding complex healthcare professional liability claims across multiple states. The position is a hybrid/work-from-home arrangement available in locations near a CNA office. Essential Duties & Responsibilities
Manages an inventory of highly complex healthcare professional liability claims with large exposures, following company protocols to verify policy coverage, conduct investigations, develop resolution strategies, and authorize disbursements within authority limits. Ensures exceptional customer service by managing all aspects of the claim, providing timely updates, and responding promptly to inquiries and requests for information. Verifies coverage and establishes reserves by reviewing policy language, estimating claim valuation, working with counsel, and following claim handling protocols. Leads focused investigations to determine compensability, liability and covered damages by gathering contracts and other documents, taking statements, and coordinating with experts as necessary. Resolves claims by developing and executing a resolution strategy, managing reserves, negotiating settlements, and collaborating with counsel on complex litigation within authority limits. Establishes and manages claim budgets by selecting resources, authorizing expenses, and delivering high-quality service efficiently. Identifies subrogation, salvage opportunities or potential fraud, referring to appropriate resources for further investigation. Maintains quality standards by ensuring compliance with both company protocols and timely, accurate file documentation and resolution of claims. Keeps leadership informed of significant risks and losses through loss summaries and succinct senior-management updates. Maintains subject matter expertise and regulatory compliance by staying current on laws, regulations and trends relevant to the line of business. Mentors and trains less experienced Claim Professionals. Skills, Knowledge & Abilities
Thorough knowledge of the professional liability insurance industry, products, policy language, coverage, and claim practices; understanding dental malpractice claims and policies is strongly favored. Strong written and verbal communication and presentation skills. Analytical and investigative mindset with critical thinking and sound decision-making abilities. Time management, organizational skills, and ability to work in a fast-paced environment. Ability to negotiate complex settlements and interpret complex insurance policies and coverage. Ability to manage multiple priorities and learn business-related software; collaborative approach valuing diverse opinions. Education & Experience
Bachelor’s Degree or equivalent experience; JD a plus. Typically a minimum of six years of relevant experience, preferably in claim handling or medical malpractice litigation. Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable. Professional designations (e.g., CPCU) are a plus. Salary note: In Chicago/New York/California, the average base pay range for the Complex Claims Consultant role is $113,000 to $160,000, with jurisdiction-based variations. The national base pay range for certain districts is $72,000 to $141,000 annually. Salary determinations depend on experience, certifications, and location. CNA offers a comprehensive benefits package; details at cnabenefits.com. CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact leaveadministration@cna.com.
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Complex Claims Consultant - Dental Healthcare at CNA Insurance. The role supports the Healthcare business, interacting with insureds, attorneys, other insurers and account representatives regarding complex healthcare professional liability claims across multiple states. The position is a hybrid/work-from-home arrangement available in locations near a CNA office. Essential Duties & Responsibilities
Manages an inventory of highly complex healthcare professional liability claims with large exposures, following company protocols to verify policy coverage, conduct investigations, develop resolution strategies, and authorize disbursements within authority limits. Ensures exceptional customer service by managing all aspects of the claim, providing timely updates, and responding promptly to inquiries and requests for information. Verifies coverage and establishes reserves by reviewing policy language, estimating claim valuation, working with counsel, and following claim handling protocols. Leads focused investigations to determine compensability, liability and covered damages by gathering contracts and other documents, taking statements, and coordinating with experts as necessary. Resolves claims by developing and executing a resolution strategy, managing reserves, negotiating settlements, and collaborating with counsel on complex litigation within authority limits. Establishes and manages claim budgets by selecting resources, authorizing expenses, and delivering high-quality service efficiently. Identifies subrogation, salvage opportunities or potential fraud, referring to appropriate resources for further investigation. Maintains quality standards by ensuring compliance with both company protocols and timely, accurate file documentation and resolution of claims. Keeps leadership informed of significant risks and losses through loss summaries and succinct senior-management updates. Maintains subject matter expertise and regulatory compliance by staying current on laws, regulations and trends relevant to the line of business. Mentors and trains less experienced Claim Professionals. Skills, Knowledge & Abilities
Thorough knowledge of the professional liability insurance industry, products, policy language, coverage, and claim practices; understanding dental malpractice claims and policies is strongly favored. Strong written and verbal communication and presentation skills. Analytical and investigative mindset with critical thinking and sound decision-making abilities. Time management, organizational skills, and ability to work in a fast-paced environment. Ability to negotiate complex settlements and interpret complex insurance policies and coverage. Ability to manage multiple priorities and learn business-related software; collaborative approach valuing diverse opinions. Education & Experience
Bachelor’s Degree or equivalent experience; JD a plus. Typically a minimum of six years of relevant experience, preferably in claim handling or medical malpractice litigation. Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable. Professional designations (e.g., CPCU) are a plus. Salary note: In Chicago/New York/California, the average base pay range for the Complex Claims Consultant role is $113,000 to $160,000, with jurisdiction-based variations. The national base pay range for certain districts is $72,000 to $141,000 annually. Salary determinations depend on experience, certifications, and location. CNA offers a comprehensive benefits package; details at cnabenefits.com. CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact leaveadministration@cna.com.
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