Claims Manager

Job not on LinkedIn

🔥 8 minutes ago

🏈 Ohio – Remote

🏈 Ohio – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 10%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Mercy Health

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🤝 Non-profit

Healthcare • Non-profit

Mercy Health is a mission-driven healthcare organization that provides direct patient care, community health services and a range of support and administrative roles. The organization emphasizes the human side of health care, compassionate, values-based service tied to a ministry mission, workforce development for bedside and support staff, flexible benefits and community outreach. Mercy Health positions itself as both an employer and community health provider focused on dignity, unity and social service.

📋 Description

• Manage liability claims, including hospital and employed physician claims and deductible-policy claims such as Cyber Liability, D&O/EPL, Regulatory, and Property/ADP • Resolve claims within available insurance coverage parameters to protect ministry assets • Represent BSMH at pre-trial hearings, mediations, arbitrations, and trials • Manage and direct defense counsel according to organizational objectives and goals • Independently evaluate, reserve, and resolve claims and litigated matters within designated authority • Use risk investigations and expert reviews to evaluate liability and causation, set reserves, assess claim values, and negotiate or resolve claims • Determine when matters should be litigated through trial • Assign and work extensively with outside defense counsel • Select medical experts to review standard of care and causation • Review defense bills using bill review software and department guidelines • Conduct insurance coverage analysis and coordinate with insurance staff on coverage issues • Identify claims for the Early Liability Review Program and monitor timely expert evaluation and notification • Explain risk evaluations and resolution or litigation alternatives to market and group senior leaders • Explain claims and litigation processes to employed physicians named in lawsuits • Coordinate with Risk Management on investigations, discovery, claim valuation, litigation, and resolution • Maintain a diary system tracking claim progression • Obtain defense counsel reports and direct litigation efforts according to department guidelines

🎯 Requirements

• Bachelors Degree in Finance, Accounting, Business, or similar field (required) • 3 years handling Professional Liability Claims or equivalent experience (required) • 5 years Claims Processing (preferred) • Associate in Claims (AIC) Certification or Associate in Risk Management (ARM) preferred • Ability to quickly learn and adapt to modern technologies as needed • Mediation training or demonstrable experience in negotiation of high value complex claims • No language requirement specified

🏖️ Benefits

• Competitive pay • Incentives • Referral bonuses • 403(b) with employer contributions (when eligible) • Medical, dental, vision, and prescription coverage • HSA/FSA options • Life insurance • Mental health resources and discounts • Paid time off • Parental and FMLA leave • Short- and long-term disability • Backup care for children and elders • Tuition assistance • Professional development support • Continuing education support

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