Provider Network Specialist, Physical Health Enrollment/Maint
Partners Health Management
General Liability Claims Consultant
CNA Insurance
full-time
Posted on:
Origin: • 🇺🇸 United States • California, Colorado
Visit company websiteSalary
💰 $72,000 - $141,000 per year
Job Level
SeniorLead
About the role
- Manage highly complex investigations of claims, including coverage issues, liability, compensability and damages.
- Determine if a major claim should be settled or litigated and implement an appropriate resolution strategy.
- Effectively manage loss costs and claim expenses and post appropriate reserves in a timely manner.
- Coordinate discovery and litigation strategy with staff counsel or panel attorneys and manage litigation activities.
- Negotiate highly complex settlement packages and authorize payment within scope of authority, ensuring timely disbursements.
- Coordinate third party recovery with subrogation/salvage unit.
- Make recommendations on claims processes and resolution strategies to management and prepare/present reports.
- Work with attorneys, account representatives, agents, doctors and insureds regarding handling and disposition of highly complex claims.
- Keep current on state/territory regulations, industry activity and trends; may participate in industry trade groups.
- Provide guidance and assistance to less experienced claims staff and ensure accurate input of claim data.
Requirements
- Bachelor's degree or equivalent experience.
- Professional designation preferred.
- Typically, a minimum eight years claims experience.
- Knowledge of and experience with New York labor law strongly desired.
- Advanced technical and product specific expertise in claims resolution and knowledge of insurance and claims principles, practices and procedures.
- Strong communication, negotiation and presentation skills.
- Ability to effectively interact with all levels of CNA's internal and external business partners.
- Advanced analytical and problem-solving skills; ability to manage and prioritize multiple projects.
- Ability to deal with ambiguous situations and issues and creativity in resolving unique and challenging business problems.
- Knowledge of Microsoft Office Suite and other business-related software.
- Ability to evaluate claims based on a cost benefit analysis and to fully comprehend complex claim facts and articulate analyses.
- Ability to implement strategies with a proactive long-term view of business goals and objectives.
