What are the responsibilities and job description for the Complex Claims Consultant - Aging Services/Medical Malpractice position at CNA?
You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential.
Healthcare Claims is recruiting for a Complex Claims Consultant position to support our Aging Services segment. Individual contributor responsible for the overall investigation and management of Aging Services claims in multiple states. Recognized as a technical expert in the interpretation of complex or unusual policy coverages in area of expertise. Under general management direction, works within assigned limits of broad authority on assignments requiring a high degree of technical complexity, coordination and excellent customer service.
CNA is a market leader in insuring skilled nursing, assisted living and independent living facilities and this role will support the business and interact closely with internal business partners such as Underwriting, to share claim insights that aid in good underwriting decisions..
This position enjoys a flexible, hybrid work schedule and is available in any location near a CNA office.
JOB DESCRIPTION :
Essential Duties & Responsibilities :
Performs a combination of duties in accordance with departmental guidelines :
- Interprets more complex or unusual policy coverages and determines if coverages apply to claims submitted, escalating issues as needed.
- Sets activities, reserves and authorizes payments within scope of authority. Ensures issuance of disbursements while managing loss costs and expenses.
- Coordinates and performs investigations and evaluates claims and suits through contact with insureds, claimants, business partners, witnesses and experts. Seeks early resolution opportunities. Identifies files that have potential fraud and refers to SIU.
- Utilizes negotiation skills to develop complex settlement packages.
- Identifies claims with third party recovery potential and coordinates with subrogation / salvage unit.
- Partners with attorneys, account representatives, agents, underwriters, doctors, nurse case managers and insureds to develop a focused strategy for timely and cost effective resolution of more complex claims.
- Analyzes claims activities. Prepares and presents reports for management. May be responsible for special projects and presentations.
- Responsible for input of data that accurately reflects claim circumstances and other information important to our business outcomes.
- May provide guidance and assistance to other claims staff and functional areas.
- Keeps current on state / territory regulations and issues as well as industry activity and trends.
- May perform additional duties as assigned.
Reporting Relationship
Typically Manager or above
Skills, Knowledge & Abilities
Education & Experience :
LI-MM1
LI-Hybrid
In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Maryland, New York and Washington, the national base pay range for this job level is $71,000 to $133,000 annually. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visit cnabenefits.com.
CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact leaveadministration@cna.com.
Salary : $71,000 - $133,000
