Senior Claims Manager – Professional Liability Program

Job not on LinkedIn

November 26

☕ Washington – Remote

Although this job is listed in Washington, this company may be open to hiring remote in other states.

💵 $65.9k - $112.7k / year

⏰ Full Time

🟠 Senior

👔 Manager

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WashU IT

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Education • Enterprise • SaaS

WashU IT is the information technology department of Washington University in St. Louis, providing essential IT services and support for the university's students, faculty, and staff. The department is integral to facilitating the university’s academic, research, and administrative functions, ensuring that technological resources and solutions are efficiently delivered and maintained across the university’s campuses. WashU IT also plays a crucial role in helping the university confront complex technological challenges and enhance its operational capabilities.

501 - 1000 employees

📚 Education

🏢 Enterprise

☁️ SaaS

📋 Description

• Analyzes and evaluates complex incident reports and lawsuits • Reviews medical records and interviews involved individuals to obtain needed information • Prepares complex investigative analytical reports for Director and Legal Counsel regarding potentially compensable incidents covered by the Self-Insured Professional Liability Program • Coordinates case development and management, participates in office management • Conducts internal claims investigations, plans defense strategies, and negotiates disposition of assigned files with guidance of legal counsel • Evaluates liability and financial exposure, approves expert witness reviews • Responds to discovery requests and answers interrogatories; coordinates witness preparations • Makes recommendations for resolution of claims • Prepares and submits required reports to Department Heads, Office of General Counsel, Director of Risk Management, and insurance carriers • Attends mediation, arbitration, and/or trial • Establishes indemnity and expense reserves based on the reserving policy • Negotiates settlements within authority • Reviews and approves defense counsel related invoices and expenses • Provides consultation and guidance on healthcare issues such as medical record release, subpoena responses, termination/transfer of care, patient complaints, and physician billing issues • Arranges for attorneys to attend depositions with physicians when necessary • Mentors less experienced claims managers.

🎯 Requirements

• Bachelor's degree • 5 years of experience analyzing or interpreting medical or other technical evidence that compares in level of complexity to medical treatment • Analytical ability to evaluate facts and formulate questions in order to define problems and critical events in the medical care rendered • General knowledge of The Joint Commission and patient safety standards, diagnosis and treatment of human disease and injury, medical therapies, procedures and standard of medical care • Knowledge of methods and techniques of individual case study, recording and file maintenance • 7 years of experience in medical malpractice claims management. • Skills: Analytical Thinking, Defining Problems, Detail-Oriented, Disease Diagnosis, Disease Management, Group Presentations, Injury Treatment, Joint Commission Regulations, Organizational Savvy, Patient Safety, Report Preparation.

🏖️ Benefits

• Up to 22 days of vacation • 10 recognized holidays • Sick time • Competitive health insurance packages with priority appointments and lower copays/coinsurance • Free Metro transit U-Pass for eligible employees • Defined contribution (403(b)) Retirement Savings Plan, starting at 7% • Wellness challenges, annual health screenings, mental health resources, mindfulness programs and courses, employee assistance program (EAP), financial resources, access to dietitians, and more! • 4 weeks of caregiver leave to bond with your new child • Family care resources for continued childcare needs • Cost of tuition covered for you and your family, including dependent undergraduate-level college tuition up to 100% at WashU and 40% elsewhere after seven years with us.