Claims Manager

Aya Healthcare; United States; Remote; USD 100,000 - 125,000; Full time

Benefits offered by this job

Free medical/dental/vision insurance

Generous 401(k) match

Bonuses at manager's discretion

Sick leave in compliance with laws

Virtual events and team-building

Unlimited DTO — time off

Job summary

Aya Healthcare is seeking an experienced Professional Liability Claims Adjuster in the United States. The role focuses on actively managing litigated claims, analyzing cases, and coordinating with Corporate Counsel to drive favorable outcomes.

The ideal candidate will have 3+ years in liability claims adjusting, a JD preferred, and the ability to manage high-volume matters in a fast-paced healthcare-focused environment.

Qualifications

• 3+ years in Professional Liability claims adjusting.
• JD preferred.
• Ability to work in fast-paced environment with large volume of matters.

Responsibilities

• Manage active and litigated Professional Liability claims; track, review, analyze, and update Corporate Counsel.
• Work with outside counsel and insurance reps to obtain up-to-date claim information and analyze reserve requests.
• Ensure compliance with state regulatory rules.
• Collaborate with medical and legal resources to pursue claim resolutions and analyze settlement authority.
• Attend mediations and trials.
• Meet with Corporate Counsel to review claims and strategy.

Skills

Claims handling

Legal terminology

Fast-paced

Education

Juris Doctor (JD)

Job description

Join Aya Healthcare, winner of multiple Top Workplace awards!

Who We Are:

We’re an $8+ billion, rapidly growing workforce solutions provider in the healthcare industry. We deliver tech-enabled services that help healthcare organizations meet and manage their contingent labor needs. We build and manage tech-enabled marketplaces for national and local healthcare talent and deliver contingent labor management solutions through our proprietary software platform.

At Aya, we’re obsessed with creating exceptional experiences for our clients, clinicians, and employees. In fact, we put employee satisfaction above all else. Our team members are responsible for incomparable customer experience and we know that happy employees are critical to maintaining happy clients. We foster an entrepreneurial, high-energy, low-bureaucracy culture and value innovative thinking and creative problem solving. We embrace diversity in thought and backgrounds unified by a commitment to high achievement. When you join Aya, you’ll be surrounded by teammates who care about you as an individual and leaders who will help you grow both personally and professionally.

Responsibilities:

• Manage active and litigated Professional Liability claims – track, review, analyze, and update Corporate Counsel on all open matters.
• Assist with claim investigations, monitor compensability determinations and review with outside counsel when necessary. Evaluate claim action plans and overall file quality to help achieve optimal claim outcomes.
• Work regularly with outside counsel and insurance representatives to obtain up to date claim information and to analyze and approve investigation and reserve requests.
• Ensure compliance with state regulatory rules and requirements.
• Collaborate with specialty resources (medical and legal) to proactively pursue claim resolutions, and analyze settlement authority requests.
• Attend mediations and trials.
• Regularly meet with Corporate Counsel to review claims and discuss claim strategy.

Qualifications:

• 3+ years prior experience in Professional Liability claims adjusting
• JD preferred
• Ability to work in fast-paced environment with large volume of matters
• Strong knowledge of claim handling policies and procedures
• Knowledge of medical terminology
• Familiarity with claims in multiple jurisdictions
• Experience working with a TPA
• Experienced in litigation and settlement negotiations
• Intermediate knowledge of PL products and ability to apply available resources and technology to resolve claims and streamline the claim process

What We Offer:

• Free premium medical, dental, life and vision insurance
• Generous 401(k) match
• Aya also offers other benefits to those that are eligible and where required by applicable law, including reimbursements and discretionary bonuses
• Aya provides paid sick leave in accordance with all applicable state, federal, and local laws. Aya's general sick leave policy is that employees accrue one hour of paid sick leave for every 30 hours worked. However, to the extent any provisions of the statement above conflict with any applicable paid sick leave laws, the applicable paid sick leave laws are controlling
• Celebrations! We hit our goals and reward ourselves.
• Company-sponsored virtual events, happy hours and team-building activities are always on the horizon — plus, you get a special treat on your birthday!
• Unlimited DTO — we believe in time off!
• Virtual yoga, meditation or boot camp classes offered daily

Compensation : Aya reasonably anticipates the pay scale for this position to be an annual salary of $100,000 to $125,000 .

The pay scale for this position may vary if applicant possesses experience outside of what Aya reasonably anticipates for this position. Bonuses are subject to the role and your manager's discretion.

Aya is an Equal Opportunity Employer (EEO), including Disability / Vets, and welcomes all to apply.