Claim Counsel – Healthcare Professional Liability

MDD Forensic Accountants

Claim Counsel managing and resolving high-severity healthcare professional liability claims. Focusing on complex insurance claims within nursing homes and healthcare facilities.

Posted 7/2/2026full-timeRemote • Alabama • 🇺🇸 United StatesSeniorLead💰 $110,000 - $135,000 per yearWebsite

About the role

Key responsibilities & impact

Review and interpret Medical Malpractice (MPL), Healthcare Professional Liability, GL, and package policies, including claims-made and occurrence forms.
Analyze coverage issues related to medical negligence, failure to provide appropriate care, medication errors, misdiagnosis, and failure to monitor patients/residents.
Evaluate coverage for facility-based exposures, including resident injuries, abuse allegations, and premises liability under GL.
Address complex issues involving policy triggers, retroactive dates, allocation between GL and PL, and multiple insureds.
Draft and issue coverage position letters, including reservations of rights and denial letters.
Oversee and manage complex claims involving nursing homes, assisted living facilities, memory care, and allied healthcare providers.
Investigate allegations including falls, pressure ulcers, failure to supervise or transfer residents, abuse or neglect claims, and medication errors or treatment failures.
Coordinate with medical experts, nurses, facility administrators, and defense counsel to evaluate liability, causation, and damages.
Analyze damages including medical costs, pain and suffering, wrongful death, and long-term care needs.
Develop and execute strategic plans for claim resolution, including oversight of litigation and multi-party claims.
Evaluate exposure and develop settlement strategies considering both professional liability and general liability components of package policies.
Recommend and manage reserves reflecting high-severity healthcare exposures.
Negotiate settlements and participate in mediations, settlement conferences, and complex litigation proceedings.
Ensure compliance with Department of Insurance requirements and healthcare-related regulatory considerations.
Maintain clear documentation of coverage analyses, claim strategy, and clinical/legal evaluations in the claims system.
Serve as a trusted advisor to carriers and internal teams on healthcare liability trends and claim strategy.
Act as the primary liaison with coverage counsel, defense counsel, healthcare providers, administrators, and brokers.
Provide clear reporting on coverage positions, exposure, and resolution strategies.

Requirements

What you’ll need

Juris Doctor (JD) with active bar membership in good standing, or 7–10+ years of senior-level experience handling medical malpractice, healthcare liability, or complex professional liability claims.
Active adjuster licenses and willingness to obtain and maintain additional licenses, as needed.
Demonstrated expertise in medical malpractice and healthcare professional liability coverage analysis.
Experience handling claims involving long-term care facilities, nursing homes, and assisted living providers.
Strong understanding of clinical exposures, standards of care, and healthcare-related damages.
Experience managing claims involving combined GL and professional liability (package) policies.
Experience issuing or advising on coverage positions.
Excellent analytical, negotiation, and communication skills.
Ability to manage multiple high-severity claims independently.
Background in long-term care programs, senior living, or allied healthcare claim programs (preferred).
Experience managing high-frequency, moderate-to-high severity healthcare claims portfolios (preferred).
Familiarity with defense counsel management, litigation strategy, and expert coordination in medical cases (preferred).
Experience working in program business or specialty healthcare liability environments (preferred).

Benefits

Comp & perks

Medical, dental, and vision plans to support your health and that of your family
A 401(k) plan with employer matching
Time‑off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non‑exempt employees
Paid holidays
Life insurance and short‑term and long‑term disability coverage
Paid sick leave, paid family and parental leave, and other mandated benefits in accordance with applicable state and local requirements

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

Claims AnalysisCoverage Position DraftingSettlement Strategy DevelopmentHigh-Severity Claims ManagementClinical Exposure Evaluation

Soft Skills

Analytical SkillsCommunication SkillsNegotiation Skills

Certifications

Active Bar MembershipActive Adjuster Licenses