CNA Insurance
Overview
Start the next chapter of your career as a Complex Claims Consultant in Healthcare for CNA Insurance. CNA is a market leader in insuring healthcare providers and facilities, including dentists, physicians, nurses, nurse practitioners, physical therapists, counselors, pharmacists, massage therapists and more than 100 other categories of medical service providers, along with the facilities and practices in which they work. This role will support the Healthcare business and interact with these key customers. You will be responsible for the overall investigation, management and resolution of Healthcare professional liability claims in multiple states. You will be recognized as a technical expert in the interpretation of complex or unusual policy coverages. Under general management direction, you will work within defined authority limits, to manage professional liability healthcare claims with moderate to high complexity and exposure in accordance with company protocols, quality and customer service standards. You will also partner with internal business partners such as Underwriting and Risk Control, to share claim insights that aid in good underwriting and risk management decisions. The individual will work with insureds, attorneys, other insurers and account representatives regarding the handling and/or disposition of complex litigated and non-litigated claims in multi-state jurisdictions. The individual will investigate and resolve claims, coordinate discovery and team with defense counsel on litigation strategy. This position enjoys a flexible, hybrid work schedule and is available in any location near a CNA office. Reporting Relationship: Typically Director or above. May perform additional duties as assigned. In Chicago/New York/California, the average base pay range for the Complex Claims Consultant role is $113,000 to $160,000. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees – and their family members – achieve their wellbeing goals. For a detailed look at CNA’s benefits, please visit 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.
Responsibilities
Manages an inventory of highly complex healthcare professional liability claims with large exposures, verifying policy coverage, conducting investigations, developing and employing resolution strategies, and authorizing 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 potential claim valuation, working with counsel and following claim handling protocols. Leads focused investigations to determine compensability, liability and covered damages by gathering documents, taking statements from customers, claimants, witnesses, and working with experts as necessary. Resolves claims by collaborating with internal and external partners to develop and execute a claim resolution strategy, managing reserves, negotiating settlements, and authorizing payments within scope of authority. Establishes and manages claim budgets by achieving timely resolution and delivering high quality service efficiently. Addresses subrogation/salvage opportunities or potential fraud by evaluating facts and referring to appropriate resources for investigation. Maintains quality standards by ensuring all protocols are followed, files are documented, and claims are resolved and paid timely. Keeps leadership informed of significant risks and losses with concise summaries for senior management. Maintains subject matter expertise and regulatory compliance by staying current on laws and trends relevant to the line of business. Mentors and trains less experienced Claim Professionals.
Qualifications
Bachelor's Degree or equivalent experience; JD is 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 are a plus (e.g., CPCU). Thorough knowledge of the professional liability insurance industry, products, policy language, coverage, and claim practices; understanding of dental malpractice claims and policies is strongly favored. Strong communication and presentation skills, both verbal and written. Analytical and investigative mindset with critical thinking skills and ability to resolve complex problems. Strong work ethic with time management and organizational skills. Ability to work in a fast-paced environment and manage multiple priorities. Experience interpreting complex insurance policies and coverage; ability to negotiate complex settlements. Knowledge of Microsoft Office Suite and ability to learn business-related software. Commitment to collaboration and valuing diverse opinions.
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Start the next chapter of your career as a Complex Claims Consultant in Healthcare for CNA Insurance. CNA is a market leader in insuring healthcare providers and facilities, including dentists, physicians, nurses, nurse practitioners, physical therapists, counselors, pharmacists, massage therapists and more than 100 other categories of medical service providers, along with the facilities and practices in which they work. This role will support the Healthcare business and interact with these key customers. You will be responsible for the overall investigation, management and resolution of Healthcare professional liability claims in multiple states. You will be recognized as a technical expert in the interpretation of complex or unusual policy coverages. Under general management direction, you will work within defined authority limits, to manage professional liability healthcare claims with moderate to high complexity and exposure in accordance with company protocols, quality and customer service standards. You will also partner with internal business partners such as Underwriting and Risk Control, to share claim insights that aid in good underwriting and risk management decisions. The individual will work with insureds, attorneys, other insurers and account representatives regarding the handling and/or disposition of complex litigated and non-litigated claims in multi-state jurisdictions. The individual will investigate and resolve claims, coordinate discovery and team with defense counsel on litigation strategy. This position enjoys a flexible, hybrid work schedule and is available in any location near a CNA office. Reporting Relationship: Typically Director or above. May perform additional duties as assigned. In Chicago/New York/California, the average base pay range for the Complex Claims Consultant role is $113,000 to $160,000. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees – and their family members – achieve their wellbeing goals. For a detailed look at CNA’s benefits, please visit 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.
Responsibilities
Manages an inventory of highly complex healthcare professional liability claims with large exposures, verifying policy coverage, conducting investigations, developing and employing resolution strategies, and authorizing 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 potential claim valuation, working with counsel and following claim handling protocols. Leads focused investigations to determine compensability, liability and covered damages by gathering documents, taking statements from customers, claimants, witnesses, and working with experts as necessary. Resolves claims by collaborating with internal and external partners to develop and execute a claim resolution strategy, managing reserves, negotiating settlements, and authorizing payments within scope of authority. Establishes and manages claim budgets by achieving timely resolution and delivering high quality service efficiently. Addresses subrogation/salvage opportunities or potential fraud by evaluating facts and referring to appropriate resources for investigation. Maintains quality standards by ensuring all protocols are followed, files are documented, and claims are resolved and paid timely. Keeps leadership informed of significant risks and losses with concise summaries for senior management. Maintains subject matter expertise and regulatory compliance by staying current on laws and trends relevant to the line of business. Mentors and trains less experienced Claim Professionals.
Qualifications
Bachelor's Degree or equivalent experience; JD is 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 are a plus (e.g., CPCU). Thorough knowledge of the professional liability insurance industry, products, policy language, coverage, and claim practices; understanding of dental malpractice claims and policies is strongly favored. Strong communication and presentation skills, both verbal and written. Analytical and investigative mindset with critical thinking skills and ability to resolve complex problems. Strong work ethic with time management and organizational skills. Ability to work in a fast-paced environment and manage multiple priorities. Experience interpreting complex insurance policies and coverage; ability to negotiate complex settlements. Knowledge of Microsoft Office Suite and ability to learn business-related software. Commitment to collaboration and valuing diverse opinions.
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