Complex Loss Specialist (Allied Health)

Job Summary:

• Specialize in Allied Health claims, adjusting the most time-intensive, complex, and high exposure losses.
• Provide analysis and presentations to senior executives and lead strategic roundtable discussions.
• Report to a Claims Supervisor or Manager and work within a collaborative team environment.

Key Responsibilities:

• Research applicable coverage, document coverage dates, limits, and restrictions, and resolve coverage questions.
• Draft reservation of rights and coverage denials, investigate facts, and secure statements and supporting documentation.
• Manage litigation, direct defense counsel and experts, and set or recommend reserves.

Qualifications:

• Minimum 10 years of claims experience with an emphasis on complex Allied Health claims.
• Active adjusters license required; college degree or equivalent claims management experience.
• Proficient computer skills including Microsoft Outlook, Word, and Excel.

Benefits:

• Comprehensive medical, dental, vision, life, and disability insurance.
• 401(k) plan with company match, employee ownership program, and time off programs.
• Work from home reimbursement, wellness programs, and professional development opportunities.