Medical Professionals Jobs in Virginia (NOW HIRING)

• Directly handle high-exposure professional lines claims, including Allied Medical, Medical Professionals, Errors and Omissions, and Management Liability matters on both primary and excess policies
• Review claims and related systems and processes
• Understand and analyze policy language and contracts
• Provide coverage, liability, and damages analysis for claims and ensure timely reserving and appropriate legal and indemnity payments
• Develop and document claim strategy for complex professional liability matters, including regulatory, licensing, credentialing, standard-of-care, causation, damages, and consent-to-settle considerations where applicable
• Draft disclaimer and reservation of rights letters
• Negotiate settlements, mitigate losses, and control expenses
• Adhere to Claims Best Practices, Key Controls, and file handling requirements
• Maintain a high level of communication with leadership and underwriting partners
• Identify trends, emerging exposures, procedural improvements, and underwriting feedback from claim activity
• Present to management, support peer development, mentor new staff, and assist with organization-wide initiatives and improvement strategies for claims and business units
• Ensure appropriate reports are timely prepared and disseminated
• Ensure successful implementation of key organization-wide initiatives and improvement strategies for claims and our business units
• Support other functional groups within the organization
• Ensure compliance with internal corporate guidelines, processes and procedures
• Other duties as required by management
• Some travel, as required for trials & mediations, etc.

• 5+ years of experience, with progressive claims handling, litigation management, or related insurance industry experience
• Experience handling claims in the Excess and Surplus market preferred
• Experience handling professional lines claims, including Allied Medical, Medical Professionals, Errors and Omissions, and Management Liability is strongly preferred
• Experience working with complex coverage issues required
• Multi-jurisdictional claims and litigation experience required
• Adjuster license and or certifications desired, but not required
• Bachelor’s degree or equivalent experience, JD desirable
• Highly advanced knowledge of claim processes, policies, procedures, claim systems, regulation, coverage, liability, damage evaluation, and/or settlement with exposures in excess of $1M
• Strong negotiating, analytical, written, and organizational skills
• Mediation and arbitration experience preferred
• Strong computer skills (Microsoft Office Suite, SharePoint, and in-house claims systems)
• Ability to prioritize and manage deadlines
• Ability to work both independently and collaboratively as part of a team
• Excellent at establishing close working relationships with other departments, including underwriting, operations, finance, IT, actuarial and legal

Demonstrates extensive experience in handling high-exposure professional lines claims, including strong analytical and negotiation skills for complex coverage issues. Proficient in developing claim strategies and ensuring compliance with corporate guidelines and best practices.

• Claims Handling Experience
• Professional Lines Claims Expertise
• Multi-Jurisdictional Litigation Experience
• Strong Negotiating Skills
• Advanced Knowledge of Claim Processes

• Claims Analysis
• Coverage Analysis
• Liability Evaluation
• Damage Evaluation
• Settlement Negotiation
• Claims Strategy Development
• Regulatory Compliance
• Mediation Experience
• Arbitration Experience
• Claims Systems Knowledge

• Analytical Skills
• Organizational Skills
• Communication Skills
• Team Collaboration
• Relationship Building

• Adjuster License
• Insurance Certifications

• Excess and Surplus Market
• Allied Medical
• Medical Professionals
• Errors and Omissions
• Management Liability
• Claims Best Practices
• Key Controls
• Claims Handling Requirements
• Licensing and Credentialing
• Consent-to-Settle

• Microsoft Office Suite
• SharePoint
• In-House Claims Systems