Claims Adjuster - US Healthcare & Medical Malpractice

A Claims Adjuster is required to further strengthen the claims team and to ensure that the Business continues to deliver a high-quality claims service to policyholders, brokers, underwriters and capacity providers. Seeking a conscientious and hardworking claims professional with experience in Healthcare claims handling – predominately Medical Malpractice in the UK.The role of the Claims Adjuster will involve working closely with colleagues within the Claims, Underwriting, Finance, IT and Products teams whilst being subject to all relevant legal and statutory (including FCA and Lloyd’s) requirements and obligations.Key responsibilities & accountabilities

• Ensure the claims department continues to act as an effective TPA for its capacity providers in accordance with binding authority SLAs & claims handling agreements, with adherence to Treating Customers Fairly (TCF) and Conduct Risk;
• Proactively handle claims in accordance with the Claims Handling Guidelines from first notification of loss (FNOL) to settlement (including coverage, legal liability and quantum analysis) within the scope of the Business's delegated authorities;
• Foster good relationships with policyholders, brokers, underwriters and capacity providers, and drive excellent customer service;
• Ensure that there is prompt and accurate reserving, identifying and pursuing relevant third party recoveries and seeking to reduce claims leakage;
• The ability to prioritise where necessary, identifying deadlines such as those stipulated within lawsuits, demand letters and in addressing claims queries;
• Work closely with the panel of service providers to ensure a quality and value for money service is provided/received within required timeframes and relevant attorney/adjuster guidelines;
• General claims administrative duties such as electronic file management filing and payment requests, and the production of management information;
• Support to the Specialty Lines Claims Manager, the Claims Director and claims team on an ongoing basis; and working closely with underwriters, attending underwriting meetings as appropriate, providing feedback on claims issues/trends and the Products team concerning the development of the products and wordings;
• Identify and escalate claims related issues to the Specialty Lines Claims Manager and the Claims Director where necessary.