
10,000+ employees
Founded 1885
π₯ Healthcare
Healthcare
Stanford Health Care is a major academic medical center and integrated hospital system delivering comprehensive clinical care, specialty services, and patient support. The organization operates hospitals, outpatient clinics and programs, offers clinical trials and telehealth (video visits), and provides patient-facing services such as a MyHealth patient portal, billing/insurance assistance, and resources for referring physicians, nurses and allied health professionals. It also engages with the community through donations, visitor services, and COVID-19 resources.
π July 14
π California β Remote
π΅ $100 - $132 / hour
β° Full Time
π’ Junior
π‘ Mid-level
π Claims Specialist
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10,000+ employees
Founded 1885
π₯ Healthcare
Healthcare
Stanford Health Care is a major academic medical center and integrated hospital system delivering comprehensive clinical care, specialty services, and patient support. The organization operates hospitals, outpatient clinics and programs, offers clinical trials and telehealth (video visits), and provides patient-facing services such as a MyHealth patient portal, billing/insurance assistance, and resources for referring physicians, nurses and allied health professionals. It also engages with the community through donations, visitor services, and COVID-19 resources.
β’ Managing, investigating, and resolving professional and general liability claims β’ Coordination with internal stakeholders and staff β’ Oversight and management of panel counsel β’ Analyzing complex medical claims and evaluating exposure and liability β’ Developing action plan for managing litigated claims β’ Evaluating insurance coverage, attending mediation and trial, monitoring litigation costs β’ Handling discovery and providing recommendations for ultimate resolution β’ Overseeing legal defense strategy and retaining outside counsel β’ Coordinating support for investigation, reviewing attorney invoices, monitoring counselβs compliance with guidelines β’ Investigating pre-suit claims, reviewing medical records, interviewing providers, retaining consultants, communicating with patients and/or families, negotiating settlements β’ Preparing claims reports and settlement evaluations β’ Maintaining accurate defense and indemnity reserves β’ Managing claims files in internal database and ensuring case information is accurate β’ Investigating cyber and privacy claims and pursuing recovery in construction and property claims β’ Assisting in other matters as assigned β’ Handling Medical Board and NPDB reporting β’ Preparing and conducting Risk Management educational presentations
β’ Juris Doctor (JD) required β’ 5 years of progressively responsible and directly-related claim management experience β’ Strong writing, communication, and presentation skills β’ Effective negotiation skills β’ Ability to analyze complex legal problems and develop solutions β’ Ability to review and evaluate medical records and literature β’ Knowledge of laws pertaining to professional and general liability litigation β’ Ability to work effectively both as a team player and leader
β’ Health insurance β’ Retirement plans
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