Remote Medical Claims Processing Jobs in Texas (NOW HIRING)

Salary: Up to $150,000 per year, dependent upon experience

Jurisdictions: Open to any

Licenses: must be willing to obtain all licenses stated by manager within specified timeframe

Location: This role is eligible for fully remote work.

The Senior Claims Specialist within GB Specialty is responsible for managing moderately complex Liability claims. This role manages the full claim life cycle, including coverage analysis, investigation, evaluation, and resolution, while ensuring claims are handled in accordance with client expectations, policy obligations, and regulatory requirements.

• Analyzes coverage and settles moderately complex Liability claims. 
• Generally, incumbent does not work on workers’ compensation claims.
• Able to manage the full-life cycle of all assigned claims files.
• Analyzes coverage and determines defense obligations.
• Under minimal supervision, conducts thorough analysis and investigations necessary to determine claims exposure and recommend appropriate settlement strategies and action plans.
• Creates reservation of rights and coverage denial letters.
• Negotiates settlements with clients, client attorneys, and Public Adjusters.
• Interacts extensively with various parties involved in the claims process, and may recommend retaining the advice of outside experts as necessary.
• Prepares reserve and settlement authority requests for client and carrier approval.
• May act as a client advocate with carriers to ensure proper claims handling, including any necessary scoping, estimating, and addressing of coverage.
• Has a solid understanding of claims processing and the insurance brokerage business.
• Has a basic understanding of the terminology and case law associated with professional liability claims.
• Handles claims consistent with clients’ and corporate policies, procedures and best practices and in accordance with statutory, regulatory, and ethical requirements.
• Incumbents at this level should be able to work at full caseload capacity.

Potential candidates should have the following:

• Claims Background: Product, Construction (CD and GL), Environmental Liability - Complex Coverage
• Jurisdictional Experience: Open to any
• Active Adjusters' licenses: must be willing to obtain all licenses stated by manager within specified timeframe

Required:

• High school diploma and 5 years related claims experience required.
• Prior experience working within the applicable specialty claims area or demonstrated ability to handle unique/challenging claims issues.
• Appropriately licensed and/or certified in all states in which claims are being handled or able to obtain the licenses/certification per local requirements.
• Knowledge of accepted industry standards and practices.
• Computer experience with related claims and business software.

Preferred:

• Bachelor's Degree preferred.
• Ten or more years of Liability claims adjusting experience.
• Law Degree (JD) highly preferred.

Behaviors:

• Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges.
• Analytical skill necessary to make decisions and resolve issues inherent in handling of claims.
• Ability to successfully negotiate the settlement and disposition of claims including the ability to interpret related documentation.

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At Gallagher, we believe supporting our colleagues goes far beyond the role itself. For more information, visit our Benefits page.

• Competitive compensation
• Comprehensive benefits programs designed to support your well-being 
• Career development opportunities and ongoing learning 
• A collaborative, people-first culture with accessible leadership 
• The opportunity to do meaningful work with global reach and local impact 

At Gallagher, we are dedicated to building an inclusive and authentic workplace. If your past experience doesn’t align perfectly, we encourage you to join our Talent Community to stay connected to additional career opportunities. At times, we will consider transferable skills from previous roles.

Gallagher is an affirmative action/equal opportunity employer (Minorities/Females/Veterans/Disabled)