RN Claims Specialist: Litigation & Risk Strategist

CHRISTUS Health; Tyler (TX); On-site; USD 85,000 - 125,000; Full time

Job summary

A CHRISTUS Regional Claims Specialist represents CHRISTUS Health and its facilities and providers, supporting the Litigation Vice President, Regional Claims Managers and the Claims Team in investigation, management, resolution and defense of disputes including claims, appeals and arbitrations.

This role requires travel (25-30%), on-site work in Texas, and strong organizational, leadership and communication skills, with RN licensure and a BSN. Prior legal exposure is preferred.

Qualifications

• BSN required.
• 3–5 years in health care with exposure to risk management or operations.
• RN license required.
• Paralegal Certificate preferred. JDs will be considered.
• Adjuster licensure and/or CPHRM certification a plus.

Responsibilities

• Supports VP of Litigation and Claims team in investigation, management, resolution and defense of claims, appeals, arbitrations, or other disputes.
• Evaluates and investigates patient and claimant complaints and recommends handling; interviews providers on site when needed.
• Produces privileged reports with clinical analysis and settlement recommendations.
• Attends depositions, trials, hearings and mediations; drafts settlement agreements as needed.
• Interacts with defense counsel and external attorneys; coordinates facility claims reviews and risk management initiatives.
• Teaches nursing residents on matters related to legal claims.

Skills

Organizational skills

Leadership

Problem-solving

PowerPoint

Excel

Education

BSN

Job description

A CHRISTUS Regional Claims Specialist represents CHRISTUS Health and its facilities and providers, supporting the Litigation Vice President, Regional Claims Managers and the Claims Team in investigation, management, resolution and defense of disputes including claims, appeals and arbitrations.

This role requires travel (25-30%), on-site work in Texas, and strong organizational, leadership and communication skills, with RN licensure and a BSN. Prior legal exposure is preferred.