Hybrid Complex Claims Consultant, Healthcare

Posted 21 hours ago

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About the role

  • Complex Claims Consultant at CNA managing highly complex commercial claims with a focus on customer service and resolution strategies. Requires strong knowledge in commercial insurance and team collaboration.

Responsibilities

  • 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

Job title

Complex Claims Consultant, Healthcare

Job type

Experience level

Mid levelSenior

Salary

$72,000 - $141,000 per year

Degree requirement

Bachelor's Degree

Location requirements

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