Complex Claims Specialist - Allied Health Care

Job Type:Permanent

Build a brilliant future with Hiscox

The Role:

The Complex Claims Specialist - Allied Healthcare is a high-level adjuster role that adjudicates assigned claims within given authority and provides operational support to the claims team. This person also:

Adjusts and resolves complex to severe claims that includes all phases of litigation

With minimal supervision, drafts complex coverage letters, including reservation of rights and denial letters

Reviews and analyses claim documentation and legal filings

Drives litigation best practices to lead defense strategy on litigated files

Mentors Claim Examiners and Associate Claim Examiners

Uses superior knowledge and experience to affect positive claim outcome via investigation, negotiation and utilization of alternative dispute resolutions

Identifies emerging exposures and claims trends

Identifies suspected fraudulent claims and tracks with special investigations unit

Accurately documents claim files with all relevant claim documentation, correspondence and notes in compliance with company policies and applicable regulatory authorities

Develops content and conducts training for claims team and underwriters as requested

The Team:

The US Claims team at Hiscox is a growing group of professionals working together to provide superior customer service and claims handling expertise. The claims staff are empowered to manage their claims within given authority to provide fair and fast resolution of claims for our insured and broker partners. With strong growth across the US business, the Claims team is focused on delivering profitability while reinforcing Hiscox’s strong brand built on a long history of outstanding claims handling

8+ years of claims handling experience within Allied Healthcare space.

A JD from an ABA accredited law school may be considered as a supplement to claims handling experience

Proven ability to positively affect complex claims outcomes through investigation, negotiation and effectively leading litigation

Advanced knowledge of coverage within the team’s specialty or focus Advanced knowledge of litigation process and negotiation skills

Experience in mentoring and training other claims examiners

Excellent verbal and written communication skills

Advanced analytical skills B.A./B.S degree from an accredited College or University preferred

What Hiscox USA Offers

Competitive salary and bonus (based on personal & company performance)

Comprehensive health insurance, Vision, Dental and FSA

401(k) with competitive company matching

24 Paid time off days + 2 Hiscox Days

10 Paid Holidays

Ability purchase 5 additional PTO days

Paid sabbaticals after 2 years of service

Dynamic, creative and values-driven culture

Modern and open office spaces, complimentary fruit and drinks

Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation

Salary Overview

$120,000 - $155,000

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Work with amazing people and be part of a unique culture

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