Claims Management Jobs in California (NOW HIRING)

Our Professional Liability team is looking for a Claims Supervisor in our San Diego office who has experience with a variety of claims management (general and premises liability, medical professional liability, employment practices liability and D&O liability) and has a passion for mentoring a team.  Our Liability team supports our members, brokers, and counsel on claims management and works as a team collaboratively across our four offices in California.  This position is eligible to telecommute up to 2 days a week from home from our San Diego office. If you have experience with claims management in the healthcare industry and enjoy mentoring and managing a team of professionals, we are looking for you! 

ABOUT BETA HEALTHCARE GROUP

BETA Healthcare Group (BETA) is the largest professional liability insurer of hospitals on the west coast, providing coverage to more than 600 hospitals and healthcare facilities and provides workers' compensation coverage for over 90,000 healthcare workers in California. BETA also has a long-established and growing commitment to physicians, providing medical professional liability coverage to nearly 7,700 physicians and more than 70 medical groups. Beyond primary liability and workers’ compensation coverage, BETA provides an entire suite of alternative risk and insurance services, including excess healthcare professional liability coverage, excess workers’ compensation coverage, third-party claims administration services, risk management consulting services and claims management consulting services. Whether with hospitals, medical groups, clinics or hospices, BETA has earned a reputation for financial strength, rate stability, quality service and breadth of coverage that is unparalleled in the industry. 

IN THIS ROLE YOU WILL:

• Train and supervise claims staff, including conducting file reviews, providing settlement authorization, ensuring compliance with Claims Department procedures, and preparing Performance Reviews
• Maintain a personal case load in accordance with Claims Department procedures and business needs
• Monitor, review, and coordinate strategy for proactive investigation, as needed, management and resolution

• Compile, analyze and document medical and legal information in claims files
• Interpret coverage contracts/policies, analyze coverage issues and make recommendations for declinations of coverage, reservation of rights letters and tenders of defense
• Suggest and approve appropriate case reserves and reserves changes as necessary
• Update claims database and paperless file as needed
• Participate in personnel decisions, including interviewing, hiring, discipline and termination of claims staff
• Actively participates in Claims Department management meetings and contributes to the formulation of administrative and Claims Department policies and procedures
• Select, direct, and monitor defense counsel and ensures compliance with the Litigation Management Guidelines and Claims Department procedures
• Communicate effectively with direct reports, members/insureds, brokers, counsel, experts and other key contacts as necessary
• Maintain personal contact with assigned accounts, if any, and provides proactive claims advice to members/insureds as necessary
• Attend mediations, court hearings, trials and meetings with members/insureds and counsel, as necessary
• Effectively analyze liability, causation, and damages issues
• Draft, review, and revise reports as necessary, including board reports, licensing agency reports and reinsurance reports
• May attend and make presentations at member/insured or BETA board meetings
• Recommend, negotiate, and authorize settlements in accordance with Claims Department procedures
• Effectively manage litigation expenses and review and approve invoices of defense counsel, experts, and vendors
• Maintain current knowledge of claims practices, trends, medicine, and legal principles
• Contribute to the continuing growth and professional development of the Claims Department
• Other duties as requested

QUALIFICATIONS:

• High School Diploma or G.E.D. required.  BA/BS degree strongly preferred
• Minimum five (5) years’ experience handling general and professional liability claims, specifically hospital and/or physician medical professional liability claims, experience handling EPL claims preferred
• AIC or commensurate insurance experience required
• In-depth knowledge of medical practices, hospital policies and procedures, legal principles and practices and insurance practices, with emphasis on healthcare-related statutes and case law
• In-depth knowledge of general and professional liability insurance policies/coverage contracts
• Excellent written and verbal communication skills
• High degree of organization and attention to detail
• Excellent analytical, interpersonal and problem-solving skills
• Ability to work independently, exercise good judgment, prioritize, meet deadlines, recognize when to escalate issues and work in a hybrid work environment
• Proficient with computers/software including Microsoft Office products

Hiring base salary range: $150,000-160,000 annually depending on experience

• This position is exempt.  Note the amount listed is the base pay range; additional compensation may be available for this position. Individual rates for the same job title may differ based on their level, responsibilities, skills, and experience for a specific role.