Professional Liability Claims Analyst

Job Description

Job Description

At OMS National Insurance Co., our mission is simple. We are dedicated to serving and protecting oral and maxillofacial surgeons and dental professionals nationwide. If you wish to be part of a growing, well-respected industry leader, OMSNIC could be the right place for you.

We offer a robust array of benefits to support our employees- generous PTO, long-term incentive plan, affordable and comprehensive benefits plans, a hybrid work schedule, tuition assistance, and opportunities to advance your career. What makes us special is our collaborative culture and the impact we make as a team.

Claims Analysts have direct contact with our policyholders and are regarded as trusted partners, managing an assigned caseload of claims. This includes the investigation, evaluation, and resolution of both pre-litigation and litigated matters.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Evaluate coverage
• Assign and collaborate with defense counsel
• Review and analyze medical records
• Investigate and evaluate issues of liability, causation, and damages, proactively moving the files toward resolution
• Participate in the formulation of case strategy
• Negotiate claims in a settlement posture
• Evaluate indemnity and expense reserves
• Prepare comprehensive claims reports
• Present claims to management and for internal review
• Keep policyholders informed of the status
• Timely and accurately document claims files
• Help maintain claim file data for accurate reporting
• Review and approve bills

General:

• Planning and participation in Risk Management and Defense Counsel Seminars
• Contribute to departmental and company goals, initiatives and projects
• May attend or participate in training and development programs
• May participate in the training and development of new hires

Education and Experience:

• Bachelor’s Degree required; might consider a demonstrated equivalent professional experience
• Minimum 3 years’ experience in the legal, insurance, or medical professional liability claims management field
• Working understanding of medical records
• Microsoft Office Suite proficiency with emphasis on Word, Excel, and PowerPoint

Competencies:

• Strong organizational and time management skills, ability to meet deadlines
• Effective written and oral communication skills to provide information in a clear and concise manner and to communicate with a variety of stakeholders
• Effective analytical and critical thinking skills to analyze facts and draw conclusions to make recommendations and resolve issues
• Ability to prepare robust reporting yet provide a broad scope overview and summary, when appropriate
• Superior customer service skills and ability to actively listen
• Strong interpersonal skills with ability to interact with policyholders, legal professionals, management, co-workers, agents, committee and board members, and external vendors
• Strong mediation and negotiation skills

Work Requirements & Physical Demands:

• Occasional travel will be required
• Occasionally might lift, carry, or otherwise move and position objects weighing up to 10 pounds
• Frequently sits for long periods of time

Work Environment:

• Performs work in an office environment (hybrid opportunity at manager’s discretion)

Salary : $70,000 to $120,000, depending on experience

Benefits:

• Medical, Dental, and Vision Insurance
• 401(k)
• Short and Long-term disability
• Life Insurance
• Employee Assistance Program
• Free onsite fitness center membership
• Long-term incentive plan
• Educational Assistance and rewards program
• Paid Time Off
• Paid Holidays
• Paid parental leave

#LI- Hybrid