Claims Manager

Aya Healthcare, Inc.; United States; On-site; USD 100,000 - 125,000; Full time

Benefits offered by this job

Medical, dental, vision insurance

401(k) match

Discretionary bonuses

Paid sick leave

Team events & birthday treat

Unlimited PTO

Daily virtual wellness classes

Job summary

Aya Healthcare, Inc. is seeking a Professional Liability claims professional in the United States. The role involves managing active and litigated claims, coordinating with outside counsel and insurers, and ensuring regulatory compliance.

JD is preferred, with 3+ years of PL claims adjusting experience and strong knowledge of settlements. We offer comprehensive benefits and a competitive salary range. The position supports a fast-paced environment with the opportunity to impact claim outcomes

Qualifications

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

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 with outside counsel and insurance representatives to obtain up-to-date claim information and analyze/approve investigation and reserve requests.
• Ensure compliance with state regulatory rules and requirements.
• Collaborate with specialty resources to pursue claim resolutions and analyze settlement authority requests.
• Attend mediations and trials.
• Regularly meet with Corporate Counsel to review claims and discuss strategy.

Skills

Fast-paced environment

Policy knowledge

Medical terminology

Multi-jurisdiction claims

TPA experience

Litigation & settlements

PL products knowledge

Education

JD preferred

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 eligibleand where required by applicable law, including reimbursementsand 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!
• UnlimitedDTO- 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.

Aya is an Equal Opportunity Employer (EEO), including Disability / Vets, and welcomes all to apply. Please click here for our EEO policy.