About the Role
The Medical Malpractice Claims Specialist is responsible for managing assigned medical malpractice claim files, including complex and high-exposure matters. This role oversees claim investigation, litigation coordination, reporting, and documentation while working closely with defense counsel and internal stakeholders. The position also supports the development and oversight of junior Claims Specialists.
Requirements
• Manage assigned medical malpractice claims from intake through resolution
• Handle complex and high exposure cases with increasing levels of responsibility
• Oversee and coordinate defense counsel in accordance with the Claims Technical Manual, Defense Attorney Guidelines, and applicable agreements
• Investigate claims including reviewing medical records, interviewing members, and corresponding with plaintiff attorneys
• Coordinate expert evaluations and obtain preliminary opinions as needed
• Prepare case evaluation reports for CRC, CSC, and discretionary authority review
• Manage discovery, mediation, negotiation, and litigation activity under supervision as required
• Monitor arbitrations and litigation progress and provide regular status updates
• Maintain accurate claims documentation, coding, and chronological records
• Timely update claims databases and index documents within the OnBase system
About the Company
Education:
• Bachelor’s degree from a four year college or university required
Relevant Background:
• Legal and or medical education background or equivalent professional experience
Claims Experience Knowledge:
• Five years of medical malpractice claims management experience or
• Three years of progressive claims handling experience