California Dental Association

About California Dental Association

About the Role The Senior Claims Representative will work remotely to manage, coordinate and appropriately direct the handling of complex dental professional liability and general liability claims, with minimal supervision, in accordance with established state mandated claims handling guidelines. Essential competencies: Critical Thinking (problem solving) Communication skills (influence) Relationship skills (collaboration) What We're Looking For Complex Claims. Manage complex dental professional liability and general liability claims from beginning to end. Problem Solving. Evaluate and make determinations on issues related to coverage; Investigate and evaluate standard of care issues; Identify, manage, and resolve all issues related to possible third party liability. Investigations. Investigate, evaluate, and collaborate with others on lawsuits (insureds, defense and plaintiff attorneys, dental consultants, staff, etc) to determine potential exposure, selection and oversight of defense counsel. Relationship Management. Retain and supervise outside adjusters, contractors, legal counsel, and dental experts to ensure efficient management of claims. Strategic Thinking. Develop defense strategies and budgets; Evaluate and establish appropriate case reserves. Meetings & Negotiations. Attend meetings with policyholders, defense attorneys, and consultants, including trials, mediations and settlement conferences; Negotiate claims resolutions with claimants and/or their legal representatives. Planning & Evaluations. Develop and document strategic plans and exposure evaluations. Budget Management. Review vendor bills to ensure they are in accordance to strategic plans and budget requirements established by file handler and authorize payment. Non-Essential Functions Completing special projects as assigned. Performs other duties as assigned Required Education, Licenses & Experience High school diploma or GED Minimum of eight years professional and general liability litigation/claims experience. Advanced knowledge of professional and general liability coverage, contracts, legal principles, California Tort Law, insurance codes, pleadings and court procedures Must demonstrate strong analytical, organizational, and planning skills. Ability to review legal documents and make coverage decisions. Proven analytical skills necessary to make decisions and resolve conflict in such areas as application of coverage to submitted claims, application of laws of jurisdiction to investigate facts, application of policy exclusions and exceptions. share goals. Excellent written and verbal communication skills necessary to effectively communicate and/or negotiate with policyholders, claimants, attorneys, agents, and general public. Demonstrated leadership capabilities to effectively train, coach, and provide feedback to less experienced associates. Strong proficiency with Microsoft Office Suite, especially with Word and Excel. Proven ability to operate personal computer with proficient use of claims and business software. Preferred Education, Licenses & Experience Bachelor's degree preferred. Advanced degrees in law, medicine, and/or related discipline desirable. Demonstrated knowledge and understanding of medical/dental terminology preferred. Why You'll Love Working at TDIC Work-Life Balance. 22 days of PTO, 11 paid holidays, we're closed every December 25th to January 1st AND it's paid! Education. Tuition reimbursement, professional development courses onsite Financial. Competitive compensation, 401k and profit sharing Health & Well-being. Impressive medical, dental and vision, flexible spending accounts; Dress For Your Day, wellness and rewards programs Culture. We're friendly, diverse, family-oriented and mission driven Parking. Parking or public transportation stipend Community. Volunteer opportunities at CDA Cares Employee Discounts. Movie tickets, cell phone discounts, theme park discounts & much more! About TDIC The Dentists Insurance Company (TDIC), a subsidiary of the California Dental Association (CDA), underwrites professional and business liability, commercial property and workers' compensation coverages exclusively for dental professionals. TDIC insures nearly 25,000 dentists nationwide and is recognized for its specialized products, risk management expertise and exceptional policyholder service. CDA is an innovative membership-based organization that's committed to the success of dental professionals in service to their patients and the public. Founded nearly 150 years ago by a small group of dentists, CDA has grown to become the single largest membership in the American Dental Association and a constant trusted resource for California dentists. CFY8U9trWx

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Company Size: 51 - 250

Revenue: 5 - 25 million (USD)

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