What are the responsibilities and job description for the Claims Consultant position at Medical Mutual Holdings?
TITLE
Claims Consultant
LOCATION
Hybrid - Raleigh, NC
About Us
Curi is a full-service advisory firm that serves physicians and medical practices. Equal parts fierce physician advocates, smart business leaders, and thoughtful partners, Curi's advisory, capital, and insurance offerings deliver valued advice that is grounded in client priorities and elevated by their outcomes. From data-driven advisory services to private wealth offerings to tailored medical malpractice insurance solutions and beyond, we deliver performance that is time-tested and trusted-in medicine, business, and life.
The Role
We're looking for a dynamic team player to join our Claims Department as a Claims Consultant covering the North Carolina market. In this role, you will help us coordinate the defense of our insured physicians. You will be responsible for investigating and managing claims, including, but not limited to, speaking with insureds and claimants, providing coverage analysis, assigning and working with defense counsel to ensure proper case management, establishing appropriate reserves, and negotiating resolution or issuing denials as appropriate.
Key Result Areas
- Act as first point-of-contact for insureds regarding general claim questions and reporting of claims.
- Perform coverage analysis and prepare reservation of rights / declination letters when appropriate.
- Work with defense counsel to develop the case to include expert support and case strategy.
- Obtain expert reviews and conduct independent investigations when no defense counsel is assigned.
- Maintain cases on the diary to ensure proper file management, evaluation, strategy, and timely reserve recommendations.
- Keep current running notes to reflect file development and ensure proper data is maintained in the claims management system.
- Negotiate claim settlements at mediation or directly with plaintiff counsel as indicated, or issue denials to claimant / claimant attorney as appropriate.
- Attend first-suit meetings, mediation, and trials.
- Attend and participate in Claims Review Committee meetings to provide strategy on claims file management.
- Willingness to travel up to 33% of the time.
Skills
Qualifications
Benefits
Curi offers eligible team members and their dependents comprehensive health benefits, including medical, dental, vision, and life insurance. Other benefits for eligible team members include education assistance, 401(k) and employer match, short-term disability, long-term disability, flexible time off, and 13 paid holidays annually.
LI-Hybrid