Healthcare Claims Adjuster: Liability & Settlements

Orlando Health, Inc.; Orlando (FL); Hybrid; USD 65,000 - 85,000; Full time

Benefits offered by this job

All Inclusive Benefits (start day one)

Job summary

Orlando Health is recruiting a Claims Adjuster to manage a caseload of third-party claims with a special focus on medical professional and general liability. The role involves coordination with legal counsel, thorough investigations and strategy development to resolve or defend claims.

Education includes a bachelor’s degree in healthcare or related field and a minimum of five years of clinical or claims adjusting experience. Strong communication and negotiation skills are essential.

Qualifications

• Bachelor’s degree in healthcare (preferred), business or closely related field.
• Five (5) years of clinical, medical-legal or claims adjusting experience.

Responsibilities

• Identify actual and potential third-party claims with a focus on professional and general liability.
• Coordinate investigations and evaluations with assigned legal counsel and Claims leadership to develop strategy to resolve or defend the claim.
• Utilize claims management and loss reduction techniques in negotiating and settling claims without legal counsel involvement.
• Participate in setting initial reserves and recommend changes to reserves on all assigned claims with Claims leadership.
• Maintain claim files with detailed documentation and correspondence with legal team and carriers.
• Serve as liaison between Orlando Health team members, physicians and legal counsel from initiation to settlement and/or trial.
• Coordinate activities for each claim with counsel, including record interpretation, retention of experts, discovery, and depositions.

Skills

Claims handling

Investigation

Negotiation

Communication

Education

Bachelor’s degree in healthcare or related field

Job description

Orlando Health is recruiting a Claims Adjuster to manage a caseload of third-party claims with a special focus on medical professional and general liability. The role involves coordination with legal counsel, thorough investigations and strategy development to resolve or defend claims.

Education includes a bachelor’s degree in healthcare or related field and a minimum of five years of clinical or claims adjusting experience. Strong communication and negotiation skills are essential.