Senior Claims Administrator

Tampa General Hospital; Tampa (FL); On-site; USD 70,000 - 100,000; Full time

Benefits offered by this job

Hybrid remote work

Job summary

Tampa General Hospital seeks a Senior Claims Administrator to manage all aspects of assigned medical malpractice and professional liability claims, including investigation, coverage determination, and litigation management.

The role requires five years of claims experience, strong analytical and negotiation skills, and the ability to coordinate with defense counsel, vendors, and experts. Part of a hybrid work environment on the TGH Main Campus in Tampa.

Qualifications

• Minimum 5 years of medical malpractice/professional liability claims experience.
• Associate degree or higher in a related field is required.
• Strong analytical and negotiation skills with ability to manage cases from intake to resolution.

Responsibilities

• Administer all aspects of assigned claims, including coverage determination and resolution.
• Investigate claims, review documents, and analyze liability and damages.
• Manage litigation with focus on early resolution and cost efficiency.
• Attend court hearings, mediations, and arbitrations as required.
• Oversee defense counsel, investigators, vendors, and experts within budget and guidelines.
• Ensure compliance with statutory and regulatory requirements including Section 111 reporting.

Skills

Claims handling

Litigation management

Regulatory knowledge

Negotiation

Communication

Education

Associate’s Degree in Paralegal studies or related field

Tools

Claims management system

Job description

Job Description - Senior Claims Administrator (260003GQ)

Senior Claims Administrator - (260003GQ)

Description

The Senior Claims Administrator is responsible for managing all aspects of assigned claims, including coverage determination, litigation management, and resolution strategies. This role involves investigating claims, analyzing liability and damages, and ensuring compliance with statutory and regulatory requirements. The administrator works closely with defense counsel, manages vendors and experts, oversees Section 111 reporting, and identifies subrogation opportunities. The position requires strong analytical, negotiation, and communication skills, as well as the ability to work independently in a fast-paced environment while adhering to company guidelines and cost-effective practices.

Essential Functions:

• Administer all aspects of assigned claims, including coverage determination and resolution.
• Investigate claims, review documentation, and maintain detailed analysis of liability and damages.
• Manage litigation with a focus on early resolution and cost efficiency.
• Attend court hearings, mediations, and arbitration proceedings as required.
• Retain and oversee defense counsel, investigators, vendors, and expert witnesses within company guidelines.
• Ensure compliance with statutory and regulatory requirements, including Section 111 reporting.
• Respond to coverage rebuttals and issue declinations when coverage does not exist.
• Identify subrogation opportunities and initiate recovery efforts in collaboration with legal counsel.
• Maintain accurate notes and diaries in the claims management system and adhere to reporting and reserve requirements.
• Participate in audits, file reviews, staff meetings, and training sessions as assigned.

Qualifications

Associate’s Degree Paralegal studies or other related field.

• Five (5) years of medical malpractice and/or professional liability claims experience.

Skills & Abilities:

• In-depth knowledge of claims handling processes, coverage analysis, and litigation management.
• Ability to investigate claims thoroughly, assess liability and damages, and develop effective resolution strategies.
• Understanding of statutory and regulatory requirements in applicable jurisdictions, including Section 111 reporting.
• Strong written and verbal communication skills for negotiating settlements and collaborating with internal and external stakeholders.
• Ability to manage defense counsel, investigators, and vendors within established guidelines and budgets.
• Skilled in claims management systems for documentation, reporting, and analysis.

Primary Location

Tampa

Work Locations

TGH Main Campus 1 Tampa General Circle Tampa 33601

Eligible for Remote Work : Hybrid Remote

Schedule

Full-time

Scheduled Days : Monday, Tuesday, Wednesday, Thursday, Friday