Claims Specialist, Healthcare
US - New YorkHybrid
AI Summary
A claims professional handling US healthcare and life sciences claims from first notification to settlement, managing stakeholder relationships and supporting claims process improvements.
About this role
We’re looking for an experienced claims professional to join CFC’s Specialty Claims team, adjusting US healthcare and life sciences claims while helping deliver a high-quality service to policyholders, brokers and capacity providers.
You’ll handle claims from first notification through to settlement, build strong stakeholder relationships and work closely with teams across Claims, Underwriting, Finance, IT and Products to support effective claims management and product development.
Key Responsibilities
- Work on US healthcare, professional indemnity and life sciences claims from first notification of loss to settlement, including coverage, liability and quantum analysis.
- Ensure claims are handled in line with CFC best practice, delegated authorities, binding authority SLAs, TCF and conduct risk requirements.
- Build strong relationships with policyholders, brokers, underwriters, capacity providers and vendors to deliver excellent service.
- Prioritise claims activity effectively, managing key legal deadlines, demand letters and claims queries.
- Work with external service providers to ensure quality, value-for-money support within agreed timeframes.
- Support claims process improvements, management information, administration and issue escalation.
- Share claims insight with Underwriting and Products to support product development and policy wording improvements.
- Obtain and maintain relevant US state claims adjuster licences, including any required examinations and Continuing Education hours.
Skills, Knowledge & Expertise
You’ll be an experienced claims professional with knowledge of professional liability and/or general liability claims, ideally with an interest in healthcare and life sciences.
Organised, detail-focused and proactive, you’ll be confident managing claims deadlines, legal documentation and stakeholder relationships while maintaining excellent customer service.
You’ll bring strong communication skills, sound judgement and a collaborative approach, with a willingness to obtain and maintain US state claims adjuster licences where required.
Organised, detail-focused and proactive, you’ll be confident managing claims deadlines, legal documentation and stakeholder relationships while maintaining excellent customer service.
You’ll bring strong communication skills, sound judgement and a collaborative approach, with a willingness to obtain and maintain US state claims adjuster licences where required.
Benefits
Love what you do:
We show up each day ready to take on the world. Our passion and intensity set us apart and makes the difference to our colleagues, customers, brokers and carriers.
Challenge everything:
We’re never afraid to question the way that things are done and we constantly challenge ourselves and others to makes things better.
Have fun, be good:
Insurance is a serious business, but we don’t take ourselves too seriously. We make it fun to work at CFC, we welcome all viewpoints, and we treat everyone how we would expect to be treated.
We show up each day ready to take on the world. Our passion and intensity set us apart and makes the difference to our colleagues, customers, brokers and carriers.
Challenge everything:
We’re never afraid to question the way that things are done and we constantly challenge ourselves and others to makes things better.
Have fun, be good:
Insurance is a serious business, but we don’t take ourselves too seriously. We make it fun to work at CFC, we welcome all viewpoints, and we treat everyone how we would expect to be treated.
Skills
Claims AdjustmentClaims Process ImprovementCoverage AnalysisLiability AnalysisQuantum AnalysisRisk RequirementsSLA ManagementStakeholder Relationship ManagementTCFUS State Claims Adjuster Licence
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