5+ years of experience
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Employment Type:
Full time
Job Category:
Claims Intake Specialist
(This job is no longer available)
ProAssurance Corporation | Birmingham, AL
Grad Date

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Job Description

An exciting opportunity exists to join the ProAssurance family of companies!

We are a specialty writer of professional liability, products liability and workers' compensation insurance. With over 1,000 employees operating in 40 states, our company is well positioned to offer career opportunities to individuals interested in professional growth.

The primary responsibility of the Claims Intake Specialist II is to be the consulting advisor on the company's coverage matters. This is achieved by being the first point of contact for our insured reporting a claim, providing independent review and analysis of court documentation, insured statements, medical records and other pertinent documentation. The person in this position must have thorough knowledge and understanding of policy language.

30% Interpret insurance contracts for all of the HCPL coverages (Professional Liability, General Liability, MedPay, Legal Defense) and for all lines of business (Physicians, Hospitals, Dentists, and Ancillary Providers), which includes:

* Reviewing and analyzing all documentation (i.e. legal documents, medical records, etc.) to determine coverage for the claim and;
* Independently examining Notice of Intent (NOI) and/or Complaint and analyze the allegations for claims exposure and;
* Analyzing and reviewing each policy to determine applicable coverage as applied to the allegations identified in the NOI and/or Complaint and;
* Analyzing and applying the claims allegations to the restrictive language in the policy to determine coverage issues and;
* Independently determining coverage and document analysis of Reservation of Rights and/or Denials, as well as appropriate legal language to be used in correspondence to insureds

30% Conduct initial telephone interview with insured to glean important facts and pertinent details of claim exposure, providing counsel and accurate information to the insured during this stressful time, advising insured on claim reporting process and explaining next steps, discussing and explaining claims process with insureds, and providing guidance, comfort, reassurance, and support to the insured as situation warrants

10% Provide consultation and advice on the company's coverage disputes

10% Recommend Claim File Type, Claims Specialist and Attorney assignments to Claims VPs and Directors

10% Serve as trainer and mentor for new or less experienced Intake staff and provide guidance and oversight to the Claims Set-up staff.

5% Review and finalize Reservation of Rights and Denial letters

* Bachelor's degree required with an Advanced degree or certification in the medical, legal or insurance field preferred. (i.e. current law student, Paralegal, R.N., J.D.)
* Proficiency in medical or legal terminology required.
* Minimum five years' professional capacity experience in in a claims, medical, or legal office environment
* Minimum 6 months multi-regional claims coverage experience
* Proficient with Microsoft Office Suite
* Proven leadership, excellent communication, and writing skills
* Strong interpersonal and relationship management expertise