Claims Consultant

Title

Claims Consultant

Location

Remote anywhere in the Midwest Region

The Role

We are looking for a dynamic team player with strong communication skills to join our Claims team as a Claims Consultant, reporting to the Director of Claims. You will support and coordinate the defense of our insured physicians, hospitals, and/or medical providers. You will be responsible for investigating and managing claims—including, but not limited to, speaking with insureds and claimants; providing coverage analysis; assigning and working with defense counsel to ensure proper case management; establishing appropriate reserves; and negotiating resolution or issuing denials as appropriate.

Key Result Areas

• Act as the first point of contact for insureds on general claim questions and claim reporting.
• Perform coverage analysis and collaborate with Curi Legal team to prepare Reservation of Rights/declination letters when appropriate.
• Work with defense counsel to develop the case, including expert support and case strategy.
• Obtain expert reviews and conduct independent investigations when no defense counsel is assigned.
• Maintain cases in a diary to ensure proper file management, evaluation, strategy, and timely reserve recommendations.
• Keep current running notes to reflect file development and ensure proper data is maintained in the claims management system.
• Negotiate claim settlements at mediation or directly with plaintiff counsel as indicated, or issue denials to claimant/claimant attorney as appropriate.
• Attend first-suit meetings, mediations, and trials.
• Attend and participate in Claims Review Committee meetings to provide strategy on claims file management.

Key Skills

• Solid understanding of basic insurance concepts, including coverage, policy language, liability, negligence, and damages.
• Strong organizational skills and ability to manage multiple tasks simultaneously.
• Effective written and oral communication skills.
• Ability to think critically and resolve problems of varying complexity.
• Ability to perform with minimal supervision.
• Self-motivated with a strong work ethic.
• Excellent customer service skills.
• Strong computer skills - experience with eOasis and OnBase is a plus.
• Proficiency with Microsoft Office Suite.
• Willingness to work flexible work hours depending on the physician’s availability to meet with the Claims team.
• Alignment with Curi's core values: accountability, curiosity, teamwork, inclusion, and service commitment. 

Travel

• Up to 10% travel (some overnight) is anticipated for this position.

Key Qualifications

Required Education and Experience

• Bachelor's degree with relevant claims, insurance, or legal experience will be considered.
• Minimum of three years of claims experience (bodily injury claims experience a plus) and/or medical malpractice defense.
• Must obtain applicable adjusters license(s) by state within three months of start date.

Preferred Education and Experience

• Juris Doctor (JD) Preferred
• Five years of medical malpractice claims and/or medical malpractice defense experience preferred.