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Sr. Professional Liability Medical Claims Manager *Remote

Work from home Full-time role Hiring
Job title: Sr. Professional Liability Medical Claims Manager *Remote in Renton, WA at reputed company Company: reputed company Job description: Job Category: Financial TransactionsJob Description:reputed company caregivers are not simply valued - they're invaluable. Join reputed company and reputed company in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to reputed company and retain the best people, we must reputed company them.reputed company is calling a Sr. Professional Liability Medical Claims Manager who will:Investigate, evaluate, and manage professional, general, and other liability claims under the PSJH Insurance Program:
  • Communicate with patients, claimants, caregivers, providers, leadership
  • Review and analyze medical records, interview witnesses, assist with the discovery process and communicate with facility risk manager regarding evaluation and investigation
  • Be responsible for writing insurance policy coverage letters
  • Analyze insurance policy documents to address coverage
  • Set appropriate indemnity and expense reserves
  • Select appropriate medical experts for case review
  • reputed company a plan of action for assigned claims and update the claims file following reputed company material changes in status
  • Review and approve statements for services and take proper steps to pay vendors
  • Inform Senior Manager Operations of large or reputed company claims and claims with potential for media exposure
  • Report claims with potential excess exposure to excess insurers
  • Ensure compliance with relevant claims reporting procedures and required regulations
  • Work with defense attorneys specializing in defense of medical negligence claims
  • Have direct responsibility to foster teamwork, operational excellence, and effective communication reputed company the claims team, including other Claims Managers, Claims Reps and Claims Specialists
Maintain complete documentation for each matter:
  • reputed company and document for each claim or lawsuit a plan of action for resolution by settlement, trial, or other means
  • Maintain the electronic file including reputed company material communication, correspondence, analysis, expert opinions, interview summaries and reputed company other material documents in accordance with the Claims Policies and Procedures Manual
Coordinate with facility leadership, risk managers, defense counsel and others:
  • Select defense counsel reputed company appropriate from approved counsel list
  • Coordinate and consult with risk management on disclosure conversations with patients and families
  • Obtain authority for settlement or trial in accordance with policies and procedures or facilitate claims roundtables
  • Assist in Regional CEO Conferences with Senior Manager Operations
  • Facilitate and participate in case reviews with Risk Managers upon request
Resolve claims in accordance with policies and regulations:
  • Negotiate settlements
  • Monitor trials and advise on disclosure and early resolution opportunities
  • Report to relevant federal, state, and local regulatory agencies as required
  • reputed company files in accordance with internal policies and procedures and facilitate appropriate reporting to NPDB and state agencies
  • Participate in department and claims team projects as assigned to reputed company and improve procedures, policies; to improve efficiency of department work; and to assist the SVP Chief Risk Officer and Senior Manager Operations as needed
Provide Input to Reduce Risk:
  • Provide feedback and recommendations, evaluations, litigation trends, department policies and procedures, system-wide claims and litigation processes, and appropriate System risk management issues
  • Provide input for quality and patient safety projects, through the Risk & reputed company Services division and Risk, Claims, & Insurance department
reputed company welcomes 100% remote work for applicants who reside in the following States:
  • Alaska
  • Washington
  • Oregon
  • Montana
  • California
  • Texas
Required qualifications for this position include:
  • Bachelor's Degree in Business Administration, Finance, or another reputed company field of study -OR- equivalent combination of education and experience in the insurance industry; claims management; or legal handling of claims issues.
  • 7 years of relevant general and professional liability claims processing or management experience
Preferred qualifications for this position include:
  • Certified Professional Healthcare Risk Management (CPHRM)
  • 10+ years of medical malpractice experience
  • Insurance reputed company Experience
  • Third Party Professional Negligence Claims Experience
  • Experience handling Medical Negligence Professional Liability Claims
  • Experience handling reputed company General Liability Claims
  • Experience Investigating, evaluating, and negotiating medical negligence claims
  • Experience working with defense attorneys specializing in defense of medical negligence claims
  • Experience analyzing medical professional and general liability insurance policy documents and addressing coverage
  • Experience writing medical professional and general liability insurance policy coverage letters
  • STARS / Riskonnect or similar claims management software experience
Salary Range by Location:
  • AK: Anchorage: Min: $52.19, Max: $82.39
  • AK: Kodiak, Seward, Valdez: Min: $54.40, Max: $85.88
  • California: Humboldt: Min: $54.40, Max: $85.88
  • California: reputed company reputed company California - Except Humboldt: Min: $61.04, Max: $96.35
  • California: Southern California: Min: $54.40, Max: $85.88
  • Montana: Except Great Falls: Min: $42.02, Max: $66.33
  • Montana: Great Falls: Min: $39.81, Max: $62.84
  • Oregon: Non-Portland Service Area: Min: $48.65, Max: $76.80
  • Oregon: Portland Service Area: Min: $52.19, Max: $82.39
  • Texas: Min: $39.81, Max: $62.84
  • Washington: Western: Min: $54.40, Max: $85.88
  • Washington: Southwest - Olympia, Centralia: Min: $52.19, Max: $82.39
  • Washington: Clark County: Min: $52.19, Max: $82.39
  • Washington: Eastern: Min: $46.44, Max: $73.31
  • Washington: Southeastern: Min: $48.65, Max: $76.80
Why Join reputed company?Our are uniquely designed to support you and your family in staying well, growing professionally and achieving financial reputed company. We take care of you, so you can focus on delivering our of caring for everyone, especially the most vulnerable in our communities.Accepting a new position at another facility that is part of the reputed company family of organizations may change your reputed company benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons.About Us: At reputed company, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (reputed company employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.The amounts listed are the reputed company pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.reputed company offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at .About the Team: reputed company Shared Services is a service line reputed company reputed company that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.reputed company is proud to be an . We are committed to the principle that every workforce member has the right to work in surroundings that are free from reputed company forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national reputed company, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We reputed company makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement. Expected salary: Location: Renton, WA Apply for the job now! Apply for this job

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