Medical Malpractice Claims Expert

The Doctors Company; Northern, New York (KY, NY); Hybrid; USD 83,000 - 118,000; Full time

Benefits offered by this job

Medical benefits

Paid time off

401(k) with company match

Life insurance

Commuter benefits

Employee assistance program

Job summary

Healthcare Risk Advisors seeks a Medical Malpractice Claims Specialist to join our claims team in a hybrid role based in Manhattan, NY. This position conducts investigations, evaluations, negotiations and settlements for a major academic health system in the NY metro, with collaboration across policyholders, attorneys and vendors.

An adjuster license or JD is required, with 2–5 years in related roles, and strong knowledge of medical malpractice law, plus excellent interpersonal and

Qualifications

• Minimum of 2-5 years as a claims adjuster, paralegal, attorney, or related experience.
• Adjusters license required, or JD in lieu of requirement.
• Excellent interpersonal and organizational skills.
• Strong knowledge of medical malpractice law.

Responsibilities

• Provides clear communication to client and follows up as necessary based on expectations agreed to with the client.
• Maintains awareness of client’s needs and context of their communication in order to provide proper support.
• Elevates concerns expressed by the insured client to management as necessary.
• Provides excellent service to team members who submit requests to the team.
• Provides high-quality, comprehensive work product that facilitates efficient/effective downstream workflow.
• Identify and elevate ERM exposure.
• Adhere to best practices.
• Understands the venues, applicable law and reserving philosophy of HRA to properly evaluate the exposures contained within the assigned caseload.
• Ensures effective documentation of established reserves.
• Provides timely analysis of cases to establish appropriate reserves.
• Escalate cases that are unique or unusual to leadership for evaluation, escalation, and communication as necessary.
• Determines the proper course of resolution based on the directed investigation by assigned staff and makes recommendations to leadership accordingly.
• Gives appropriate insight and advice to clients, staff and defense counsel on the best possible outcome for both the insured client and the company.
• Completes coverage analysis and requests coverage review as appropriate.
• Makes appropriate and decisive decisions to establish a plan of action on all cases assigned to the team.
• Directs all reporting to High Exposure Committee and Reinsurers as necessary.
• Makes recommendation for assignment of litigated matters to appropriate defense panel members based on ability and experience.
• Partners with defense counsel for optimum outcome on all assigned cases.
• Monitors and approves fees and expenses within authority to comply with company guidelines and state statutory guidelines.
• Attends and monitors (directly or indirectly) settlement conferences, mediations and trials, reports out timely and insightfully, and escalates as needed.
• Evaluates attorney work product/performance and advises supervisor of any need for corrective action or improvement.
• Recommends the proper course of resolution timely to leadership and/or client based on the investigation and discovery.

Skills

Interpersonal skills

Organizational skills

Medical malpractice law

Education

Adjuster license

JD

Job description

Healthcare Risk Advisors seeks a Medical Malpractice Claims Specialist to join our claims team in a hybrid role based in Manhattan, NY. This position conducts investigations, evaluations, negotiations and settlements for a major academic health system in the NY metro, with collaboration across policyholders, attorneys and vendors.

An adjuster license or JD is required, with 2–5 years in related roles, and strong knowledge of medical malpractice law, plus excellent interpersonal and