The Claims Specialist is responsible for investigating and evaluating claims, reviewing medical records, corresponding with Claimants and/or their Attorneys, obtaining preliminary expert evaluations, and preparing interview summaries. The Claim Specialist will assign, direct, and control outside defense counsel according to the standards set forth in the litigation guidelines.
The candidate will review all bills for reasonableness and to confirm attorney's fees and defense costs are within the budgeted amount and that the litigation plan is being followed. Excellent written and verbal communication skills are required to prepare case evaluation reports for presentation to the claims committee for discretionary settlement authority on cases. Organizational skills are required to maintain an active diary, and to manage litigation activity, including discovery plans, mediation dates, and trials dates. A professional demeanor is required to advance productive communications with Claimants, Attorneys and colleagues.
Bachelor's degree obtained through a formal 4-year program. Two years of related experience.
State of Florida Department of Insurance Independent Adjuster 620-license required within 6 months of hire/transfer. State of Florida Healthcare Risk Management License preferred.
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