Claims Consultant – Liability Professional (Med Mal / General Liability)
Location: Remote or hybrid within the State of Louisiana. Must reside in Louisiana.
Work Location: 100% remote or hybrid.
Position Summary: Manage medical malpractice, general, and auto liability claims, including investigation, evaluation, reserving, negotiation, settlement, and closure for a well‐known Louisiana‐based insurance carrier. Foster a client‐service culture that encourages out‐of‐the‐box thinking and supports career growth.
Qualifications
Minimum 5 years experience as a desk adjuster handling liability or medical malpractice claims (or equivalent).
Direct experience adjusting Louisiana claims as a W2 full adjuster at an insurance carrier.
Experience interacting with account customers and (plus) familiarity with hospital/healthcare clientele.
Professional demeanor, client‐facing appearance, and strong communication/interpersonal skills.
Ability to present to groups and deliver CEUs/claims reviews.
Proactive, continuous learner, organized with a knack for process improvement.
Computer skills; experience with claims management software.
Professional home office; ability to work independently and collaborate with others.
Willingness to travel within Louisiana as needed.
Essential Functions & Responsibilities
Determine coverage applicability for submitted claims, complaints, or suits in collaboration with Underwriting.
Coordinate investigations, including recorded statements, scene investigations, photographs, and videos.
Assign defense counsel as appropriate.
Evaluate claims in coordination with defense counsel.
Identify and pursue all sources of third‐party liability for recovery.
Obtain necessary medical records and establish liability/compensability.
Set and monitor reserves based on company guidelines.
Maintain updated diaries, document file notes, and store documents per retention guidelines.
Attend mediations, trials, and medical review panel meetings as appropriate.
Coordinate and perform client claim review meetings.
Report to reinsurance and excess carriers when claim files meet reporting requirements.
Negotiate and settle claims with claimants or legal representatives within scope of authority.
Control costs of outside vendors providing claim‐related services.
Assess education needs of clients and areas of loss‐control improvement with Risk Management.
Pursue continuing self‐development and education.
Follow established company policies and procedures.
Maintain HIPAA privacy standards for all claims.
Manage litigation processes and assist counsel with defense of the claim/case.
Perform other duties as needed.
Reporting Relationship
Reports to the Vice President of Claims Operations.
Seniority Level
Mid‐Senior level
Employment Type
Full‐time
Job Function
Finance and Sales
Industries
Insurance
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