Complex Claims Consultant, Healthcare
CNA Insurance
full-time
Posted on:
Location Type: Hybrid
Location: Lake Mary • California • District of Columbia • United States
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Salary
💰 $72,000 - $141,000 per year
About the role
- Manages an inventory of highly complex commercial claims, with large exposures
- Coordinates all claim resolution activities in accordance with company protocols
- Achieves exceptional customer service by managing all aspects of the claim
- Verifies coverage and establishes timely and adequate reserves
- Leads focused investigation to determine compensability and liability
- Resolves claims by collaborating with internal and external business partners
- Establishes and manages claim budgets
- Realizes and addresses subrogation/salvage opportunities or potential fraud occurrences
- Achieves quality standards by managing each claim appropriately
- Keeps senior leadership informed of significant risks and losses
- Maintains subject matter expertise and ensures compliance with state/local regulatory requirements
- Mentors, guides, develops and delivers training to less experienced Claim Professionals
Requirements
- Bachelor's Degree or equivalent experience
- Typically a minimum six years of relevant experience, preferably in claim handling
- Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable
- Prior negotiation experience
- Professional designations preferred (e.g. CPCU)
Benefits
- comprehensive and competitive benefits package to help our employees
- physical, financial, emotional and social wellbeing goals
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
claim resolutioncoverage verificationbudget managementinvestigationnegotiationsubrogationsalvagefraud detectioncustomer servicecompliance
Soft Skills
leadershipmentoringtrainingcollaborationcommunicationproblem-solvingorganizational skillsrisk managementquality managementdevelopment
Certifications
Bachelor's DegreeInsurance Adjuster LicenseCPCU