Support PDF,DOC,DOCX,TXT,XLS,WPD,HTM,HTML fils up to 5MB
Years of Experience
Date Last Verified
ProfileRegional General Adjuster Duties: Fully responsible for the investigation, evaluation, negotiation, and resolution of claims which are the most complex in coverage and represent the company’s largest damage exposures. The claims could originate anywhere in the country and often require field consultation, field investigation and providing a high level of technical expertise to many professionals throughout the country. Claims include Nursing Homes, Long Term Care/ Eldercare/Aging Services segments and could include Human & Social Services. Analyze large quantities of medical records and discern key issues Work with high authority limits on assignments reflecting a very high degree of technical complexity and coordination. Possesses a high and extensive level of technical knowledge and skills including product and industry for Healthcare Liability. Negotiate settlements, mitigate losses, and control expenses on our company’s largest losses. Responsible to provide consultation and participation in the development of large claim strategies. Other duties as assigned.
Qualification and Experience
Requirements: Bachelor’s Degree or insurance related equivalent required; RN and/or JD Degree preferred. 8+ years of insurance claim experience managing professional liability claims for healthcare business segment which include Nursing Homes, Long Term Care/ Eldercare/Aging Services segments and could include Human & Social Services. 8 - 10 years professional experience. Makes decisions in an informed, confident and timely manner. Dedicated to meeting the expectations and requirements of internal and external customers. Maintains constructive working relationships despite differing perspectives. Strong organizational and time management skills. Ability to negotiate skillfully in difficult situations with both internal and external groups. Demonstrates ability to win concessions without damaging relationships. Demonstrates strong written and verbal communication skills. Promotes and facilitates free and open communication. Understanding of applicable statutes, regulations and case Law. Must be an excellent on interpreting liability coverage and have the ability to quickly analyze large quantities of medical records and discern key issues; create a plan for strategic claim evaluation; and direct outside counsel to most efficiently resolution. Should have the ability to function independently as well as in an environment of teamwork and collaboration. Ability to navigate difficult situations with both internal and external groups.