Senior Complex Claims Consultant / Claims Counsel - Healthcare Professional Liability

Davies
United States
Workplace: RemoteFull timeUSD 110,000 - 135,000 annuallyFunction: Healthcare (Clinical, Medical, Wellness)Experience: 7-10 yearsEducation: professionalSkills: ["Analytical","Negotiation","Communication","Independent claim management"]

Manage and resolve high-severity healthcare professional liability and medical malpractice claims with a strong focus on coverage analysis, policy interpretation, and strategic resolution. Serve as a healthcare liability coverage subject matter expert for complex cases involving nursing homes, assisted living, and allied healthcare providers. Conduct investigations, assess damages and reserves, draft coverage position letters, and coordinate with medical experts and defense counsel to negotiate settlements and oversee litigation.

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Davies
Davies
2 months ago

Senior Complex Claims Consultant / Claims Counsel - Healthcare Professional Liability

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Last checked: 12 hours agoStatus: Live

Job Summary

Manage and resolve high-severity healthcare professional liability and medical malpractice claims with a strong focus on coverage analysis, policy interpretation, and strategic resolution. Serve as a healthcare liability coverage subject matter expert for complex cases involving nursing homes, assisted living, and allied healthcare providers. Conduct investigations, assess damages and reserves, draft coverage position letters, and coordinate with medical experts and defense counsel to negotiate settlements and oversee litigation.
Location: United States
Workplace: Remote
Employment Type: Full time
Job Function: Healthcare (Clinical, Medical, Wellness)

Key Responsibilities

  • •Review and interpret medical malpractice (MPL), healthcare professional liability, GL, and package policies, including claims-made and occurrence forms.
  • •Analyze complex coverage issues (e.g., triggers, retroactive dates, allocation between GL and PL, multiple insureds) and draft coverage position letters, reservations of rights, and denial letters.
  • •Oversee investigations and manage high-severity claims involving nursing homes, assisted living, memory care, and allied providers.
  • •Coordinate with medical experts, nurses, facility administrators, and defense counsel to evaluate liability, causation, and damages and develop strategic resolution plans.
  • •Evaluate exposure, recommend and manage reserves, negotiate settlements and participate in mediations and settlement conferences while maintaining compliant documentation in the claims system.

Pay and Benefits

Salary: USD 110,000 - 135,000 annually
Perks:Health InsuranceDentalVision401kPaid LeavePaid HolidaysLife InsuranceDisability InsuranceParental Leave

Key Requirements

  • •Juris Doctor (JD) with active bar membership in good standing, or 7–10+ years of senior-level experience handling medical malpractice, healthcare liability, or complex professional liability claims.
  • •Active adjuster licenses and willingness to obtain and maintain additional licenses as needed.
  • •Demonstrated expertise in medical malpractice and healthcare professional liability coverage analysis.
  • •Experience handling long-term care facility claims, including nursing homes and assisted living providers.
  • •Strong understanding of clinical exposures and healthcare-related damages, including combined GL and professional liability (package) policies and issuing coverage positions.
Experience:7-10 yearsInsuranceHealthcareMedical malpracticeProfessional liabilityLong-term care
Education:Professional (JD, MD, etc.)
Skills:AnalyticalNegotiationCommunicationIndependent claim management
Certifications:Active bar membershipAdjuster licenses

Company Brief

Davies
Davies is a specialist professional services and technology firm delivering claims, underwriting, and risk solutions to insurers, reinsurers, brokers and regulated businesses globally, with major capabilities in claims management, forensics, and digital transformation.
Industry: Consulting
Company Size: Enterprise (1,001+ employees)
Revenue: USD 1B+
Growth: Established Company
Valuation: Unicorn (USD 1B+)
Funding: Private Equity Backed
Headquarters: City of London, United Kingdom
Founded: 1968
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