A strong, trusted insurance partner, Berkshire Hathaway Specialty Insurance (BHSI) provides a broad range of commercial property, casualty and specialty insurance coverages and outstanding service to customers around the globe. Part of Berkshire Hathaway’s insurance operations, we bring our solutions to market with our stellar brand name, top-rated balance sheet, and the expertise of our global team of professionals with excellent capabilities and character. Want to be part of the team building the finest property, casualty and specialty lines insurance company in the world?
Berkshire Hathaway Specialty Insurance is seeking a medical risk consultant to join their medical stop loss team. The ideal candidate will utilize professional and clinical knowledge to assess risk. These activities will provide BHSI medical stop loss underwriters, claim auditors and external clients with appropriate clinical assessment of the anticipated care needs and potential costs of identified claimants. This position can be remote for the right candidate or based from our Atlanta, Indianapolis, or Irvine office locations.
Duties & Responsibilities:
• Effectively explain complex clinical conditions to internal and external clients.
• Build strong relationships with internal (UW’s, Claims) and external clients (TPA’s, external CM’s) to communicate risk factors and projected cost of claims.
• Evaluate and assess both new business and renewal large claims/disclosure, clinical and claims data to identify known and potential risks and make potential cost recommendations to the stop loss underwriting team
• Serve as the lead resource for underwriting in identifying potential large claims, and to project the expected cost of the potential claim.
• Quickly, thoroughly, and correctly assess a potential/actual claim situation to successfully influence risk decision makers, resulting in meaningful clinical and/or financial outcomes.
• Document and effectively communicate claim projections and rationale to stop loss underwriters.
Qualifications, Skills and Experience:
• Bachelor’s Degree or equivalent combination of education and work experience
• RN license required
• Five years of relevant experience, preferably with stop loss carrier
• Prior clinical experience preferred
• Working knowledge of stop loss insurance policy and contract language
• Would prefer knowledge of ESL Office, particularly the Underwriting, Claims and Policy Administration modules.
• Working knowledge of Microsoft Excel
• Excellent oral, written, and interpersonal communication skills to achieve positive outcomes
• Detail oriented
• A competitive package and exciting growth opportunities with a growing global organization
• A liberating, fast-paced culture, centered on always doing the right thing for our customers, teammates and our business
• A purposely non-bureaucratic organization that embraces simplicity over complexity, encourages innovation, and emphasizes individual excellence in a team framework
NOTE: This job description is not intended to be all-inclusive. Team Member may perform other related duties as negotiated to meet the ongoing needs of the organization
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