AvonRisk is the nation’s leading specialty risk manager for self-insured organizations, uniting respected regional leaders in workers’ compensation, liability, managed care, and risk management across 32 states. With nearly 700 professionals and brands including Intercare, InterMed, George Hills, and AS&G Claims Administration, we’re a people-focused, operations-driven organization that prioritizes reasonable caseloads, strong training, collaborative teams, and expert support. We invest in tools and workflows that reduce friction—not increase volume—and create real career paths for professionals who want to grow their careers or move into leadership. We are a focused, operations driven organization that prioritizes reasonable caseloads, strong training, collaborative teams, and expert support.  At AvonRisk, you’re part of a team that values good judgment, curiosity, and accountability, and gives you the support to succeed.  

Summary:

This is a dynamic claims and account management   position. In accordance with applicable statutes and in keeping with company rules, regulations, client guidelines and established performance objectives is   responsible for effectively managing to conclusion an assigned inventory of medical professional and general liability claim files that may include cases of  extreme complexity or with unique or unusual issues.

Essential Duties and Responsibilities: 

• Maintain culture of positivity, respect, supportiveness, collaboration, patience, accountability and excellence. 
• Assist with team building ideas and events.
• Lead by example and through service.
• Develop and maintain strong and collaborative client relationships. 
• Establish prompt contact on all new losses within 24 hours of receipt of the claim to include the insured, claimant, or claimant representative to document relevant facts surrounding the incident itself as well to obtain information relevant to analysis of liability and damages.
• Thoroughly and accurately evaluate coverage on a timely basis, document coverage analysis, identify coverage issues and draft appropriate coverage letters.
• Thoroughly and accurately investigate all claims and document ongoing case facts and relevant information necessary for establishing liability and damages, perform and document ongoing analysis and evaluation and document what is being done to move the case toward closure.
• Litigation management - Direct, manage, and control the litigation process for nationwide programs.
• Assure that all assigned claims are maintained on an active 30 to 45 diary and have an up-to-date plan of action outlining activities and actions anticipated for ultimately resolving the claim.
• Obtain consultant and/or expert reviews for early evaluation.
• Aggressively pursue contribution on multiple defendant cases or where provided by employment or independent contractor agreements and apportionment when there is shared liability.
• Assure that the claim file is handled in accordance with applicable statutes as well as in-force service contracts and company guidelines. 
• Establish, monitor, and adjust claim reserves in strict accordance with assigned authority levels and client claim handling instructions.
• Exhibit and maintain a courteous and helpful attitude and project a professional image on behalf of the company and client.
• Respond to telephone messages and inquiries within 24 hours of receipt and to written inquiries within one week of receipt. 
• Travel for mediations, trials, client meetings and/or industry related conferences. 
• Requires a working knowledge of medical terminology and various jurisdictional issues.
• Handle other duties and tasks as deemed appropriate by the Supervisor or Manager 

Competency:

To perform the job successfully, an individual should demonstrate the following competencies: 

• An open mind, an eagerness to learn, a positive attitude and healthy curiosity. 
• Strong communication skills including being open and respectful of everyone, regardless of their position or role in the world. 
• Flexibility and the ability to adapt to change quickly. This includes the ability to switch gears efficiently between various program needs, and client and colleague personalities numerous times throughout the day. 
• Problem solving, change and conflict management including being able to develop workable implementation plans and recommendations, communicating changes effectively, building commitment and overcoming resistance, and preparing and supporting those affected by change and conflict. 
• Leadership by example and service, including instilling and exhibiting confidence in yourself  and others, inspiring and motivating others to perform well, ethically and positively influencing the actions and opinions of others, inspiring  respect and trust, accepting and growing from the feedback from others, providing vision and inspiration to all colleagues, providing appropriate recognition to others, displaying passion and optimism, mobilizing others to fulfill the vision, accepts responsibility and accountability. 
• Exceptional customer service including always going above and beyond for clients, searching for ways to expand our services for each client, soliciting client feedback to improve service, promptly responding to all client needs and requests and ensuring compliance with client contracts and service instructions. Responds to requests for service and assistance. Meets commitments.
• Strong business acumen including being well spoken, displaying poise, presenting yourself and Intercave with a measured balance of confidence and humility, taking initiative, sparking innovation, understanding the business implications of decisions, displaying orientation to profitability, demonstrating knowledge of the market and competition, and aligning work with strategic goals.
• Discipline in all aspects of the position with a focus on accuracy, thoroughness and constant desire for improvement.
• Project management skills, including developing project plans, coordinating projects, staying/keeping on task, communicating changes and progress, and completing projects on time and budget.

Qualification   Requirements: To perform this job successfully, an individual must, at a   minimum, be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or   ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

Education and/or Experience: JD and/or RN preferred. Bachelor's degree from four-year college or   university; at least seven years related experience and/or training; or equivalent combination of education and experience. Requires a high degree of claims handling expertise to include a minimum of at least five years' experience managing medical professional liability cases, many with complex litigation or high potential value. 

Language Skills: Ability to read, analyze, and interpret insurance   policies, statutes, legal opinions, general business periodicals, professional journals, technical procedures, and governmental regulations.   Ability to write complex coverage letters, reports, business correspondence, procedure manuals, and correspondence to clients, colleagues and industry   peers. Ability to effectively present information, both verbally and written, and respond to questions from groups of managers, clients, customers, and the general public. Fluent spoken and written English is required.  

Math Skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.   Ability to compute rate, ratio, and percent and to draw and interpret bar graphs. 

Reasoning Ability: This position requires strong problem solving and analytical skills. It requires the ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.  It requires the ability to deal with problems involving several concrete variables in standardized situations. 

Computer Skills: To perform this job successfully, an individual must be proficient with Word, Excel, Outlook, PowerPoint, RMIS software, RingCentral, Zoom, TEAMS, WebEx, GoToMeeting and other tele-video conferencing software and apps. 

Certificates and Licenses: JD and or RN licensure preferred. Appropriate jurisdictional adjuster license required.  

Physical   Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Salary Range: $100,000 - $120,000 annually

Benefits: 

We take care of our people so they can take care of their work and their teams! AvonRisk offers a competitive, people first benefits package designed to support your health, financial security, and career growth, including:

• Comprehensive medical, dental, and vision benefits 
• Company contributions to HSA and FSA plans 
• Employer paid life and disability insurance 
• 401(k) with company match 
• Paid time off (PTO) and company paid holidays 
• Learning and development opportunities that support real career advancement 
• Employee assistance resources and a supportive culture that values balance and wellbeing 

We’re an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status. 

Pursuant to the Los Angeles and San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest or conviction records. 

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