Complex Loss Specialist (Allied Health)

TL;DR

Complex Loss Specialist (Allied Health): Adjusting high-exposure and time-intensive healthcare liability claims with an accent on medical record interpretation and litigation management. Focus on evaluating legal liability, directing defense counsel, and determining optimal resolution strategies for complex professional liability losses.

Location: Remote (United States). Must be legally authorized to work in the US.

Salary: $87,000 - $109,000 USD

Company

An Insurtech powerhouse combining insurance and technology to optimize engagement through data and AI/ML.

What you will do

• Adjust the most complex, high-exposure Allied Health claims requiring high technical expertise.
• Perform deep coverage analysis and interpret professional liability policies, including limits and exclusions.
• Investigate loss facts by securing statements and analyzing medical records across various allied health disciplines.
• Manage litigation by assigning and directing defense counsel, independent medical examiners, and expert witnesses.
• Evaluate and set reserves based on exposure analysis and prepare detailed reports for Senior Executives.
• Maintain productive relationships with underwriters, agents, and clients.

Requirements

• Minimum 10 years of claims experience, specifically focused on complex Allied Health claims.
• Active individual adjusting license for a designated home state.
• College degree or equivalent claims management experience.
• Minimum 10 years of litigation management experience preferred.
• Must be legally authorized to work in the United States (E-Verify participant).
• Proficiency in Microsoft Office (Outlook, Word, Excel).

Culture & Benefits

• Employee Ownership Program allowing employees to share in the company's financial growth.
• Comprehensive medical, dental, and vision insurance with HSA company contributions.
• 401(k) plan with company match contribution.
• Work from home reimbursement for remote roles.
• Paid time off and 11 company-paid holidays.
• Access to professional development and wealth financial wellness programs.