Complex Claims Consultant , Medical Malpractice and Dental

You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we work to create a culture where people know they matter and are part of something important, ensuring that the abilities of all employees are used to their fullest potential.

Responsibilities

• Manage an inventory of highly complex commercial claims with large exposures that require specialized technical expertise and coordination.
• Verify policy coverage, conduct investigations, develop resolution strategies, and authorize disbursements within authority limits.
• Provide exceptional customer service, interacting professionally and effectively, achieving quality and cycle‑time standards, and responding promptly to inquiries.
• Estimate reserves and claim valuation, partnering with coverage counsel on more complex matters.
• Lead focused investigations to determine compensability, liability, and covered damages via gathering evidence, taking statements, and working with experts.
• Collaborate with internal and external partners to develop, own, and execute a claim resolution strategy, including settlement negotiation and litigation management.
• Manage claim budgets by selecting and overseeing resources, authorizing expense payments, and delivering high‑quality service efficiently.
• Explore subrogation, salvage, and fraud opportunities, making referrals to appropriate recovery resources.
• Maintain compliance with state and local regulations and stay current on commercial insurance laws and trends.
• Mentor, guide, and develop less experienced claim professionals.
• Perform additional duties as assigned.

Reporting Relationship

Typically reports directly to a Director or higher-level executive.

Skills, Knowledge & Abilities

• Thorough knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices.
• Strong verbal and written communication and presentation skills.
• Analytical and investigative mindset with critical thinking and sound business decision‑making.
• Time‑management and organizational skills; ability to work in a fast‑paced environment.
• Experience negotiating complex settlements and managing multiple shifting priorities.
• Proficiency with Microsoft Office Suite and ability to learn business‑related software.
• Ability to value diverse opinions and ideas.

Education & Experience

Bachelor’s Degree or equivalent experience; typically a minimum of six years of relevant claim‑handling experience.

Licensing

Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable.

Hybrid Work Model

The position offers a hybrid work schedule, combining remote and onsite responsibilities.