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Overview

Description

The Risk Management Specialist works within the department of Risk Management, using the latest technology to create and execute Certificates, Vehicle Driver evaluations, Drug program monitoring, and manage routine to moderately complex claims from the investigation of an event through resolution. This includes making decisions about liability/compensability, evaluating losses, managing relationship with the carrier claims adjuster, nurse case managers and stakeholders within MC Dean, Inc. The position handles insurance claims and information on a global platform.

This is an in-office position in Tysons, Virginia

Responsibilities:

+ Manages an inventory of claims to evaluate compensability/liability.

+ Works with internal stakeholders, adjusters, and General Counsel on action plans based on case facts, best practices, protocols, regulatory issues and available resources.

+ Plans and conducts investigations of claims to confirm coverage and to determine liability, compensability and damages.

+ Assesses policy coverage for potential GAPS in coverage; review the established reserve requirements, identified claims for subrogation and/or Special Investigations Unit as appropriate.

+ Assesses actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims.

+ Performs other duties as assigned.

Qualifications

+ Proven interpersonal, analytical and negotiation abilities required.

+ Ability to provide information in a clear, concise manner, ability to build effective relationships.

+ Bachelor`s degree with 0-2 years of experience or equivalent experience in risk management. Knowledge of legal liability, insurance coverage and medical terminology preferred.

+ Ability to multi-task and work within fast paced environment with competing priorities and quick deadlines.

+ Prioritizing critical events and communicating them effectively

+ Attention to detail

+ General understanding of the Claim handling process

Computer Skills

+ Knowledge and abilities of Microsoft suite of applications with special emphasis on excel and the ability to pivot tables and provide information in clear concise and accurate format.

+ Rapidly develop skills in the multiple software platforms

Abilities:

+ Exposure to computer screens for an extended period of time.

+ Sitting for extended periods of time.

+ Reach by extending hands or arms in any direction.

+ Have finger dexterity in order to manipulate objects with fingers rather than whole hands or arms, for example, using a keyboard.

+ Listen to and understand information and ideas presented through spoken words and sentences.

+ Communicate information and ideas in speaking so others will understand.

+ Read and understand information and ideas presented in writing.

+ Apply general rules to specific problems to produce answers that make sense.

+ Identify and understand the speech of another person.