Senior Healthcare Risk & Claims Analyst

kansashealthsystem; Olathe (KS); On-site; USD 55,000 - 85,000; Full time

Job summary

Kansas Health System in Olathe, KS seeks a Risk Claims Analyst to support the Risk, Claims, and Insurance Department. Responsibilities include research, reporting, underwriting coordination, and timely claims processing to ensure accurate reporting.

The role requires an Associate degree and 5+ years in healthcare risk/claims administration; a Bachelor's degree or professional designations are preferred. Full-time day shift in the Olathe Medical Pavilion B location.

Qualifications

• Associates Degree from an accredited College or University.
• 5 or more years broad administrative/project coordination/ or risk, insurance, and claims management in a healthcare environment

Responsibilities

• Represents department management for communicating information to hospital executive team, vendors, physicians, staff, and community agencies.
• Provides support to all aspects of insurance program, i.e., renewal/underwriting requests, certificate of insurance coordination, adding and terming provider coverage and tracking refunds.
• Provides support in handling general liability, property and auto claims; including coordination of claims.
• Coordinates responses to litigation discovery Utilizes database to document matter activities and correspondence.
• Escalates claim concerns to the team.
• Composes correspondence, memos, newsletter pieces, website content, policies, reports: types and proofs materials; edits, collates, assembles, and distributes documentation as needed.
• Prepares reports, activities calendars, mass mailings (i.e., letters and memos for staff).
• Assists with creation of database structure, gathers and analyzes data, and distributes reports as needed to support department operations.
• Demonstrates competencies in computer programs such as: Microsoft Office Word, Excel, PowerPoint, and Outlook, as well as other intra/internet programs.
• Prioritizes correspondence, memos, reports, and internal signature files and appointments; Reviews, classifies, and files correspondence, documents, and materials in main filing system; secures confidential file system dealing with sensitive documentation.
• Assists with the development, implementation and monitoring of the claims management program for the organization
• Participates on various Patient Relations committees such as a Grievance and Appeal committee as a member and consultant
• Serves as a proactive resource to departments and committees to promote safe and quality patient care and reduce liability exposure.
• Exercises professional judgment and critical thinking in facilitating prompt and compassionate claims management.
• Coordinates with the Directors the development and presentation of educational programs on risk management issues and claims trends.
• Promotes the containment of claims and losses, through early identification, assessment and resolution.
• Acts as liaison between the Board of Healing Arts and UKP physicians by serving as point of contact and negotiating submission terms for complaints.
• Assists and participates with the Directors of Claims, Insurance and Risk Management, in early communication and resolution protocol in response to unanticipated negative outcomes of care
• Works effectively with TUKHS Compliance, Risk Management, and other departments to provide information related to claims and insurance.
• Participates in education and orientation of new physicians as requested.
• Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.

Skills

Administrative coordination

Risk management

Claims management

Data analysis

Communication

Education

Associate degree

Bachelor's degree (preferred)

Tools

Microsoft Office

Job description

Kansas Health System in Olathe, KS seeks a Risk Claims Analyst to support the Risk, Claims, and Insurance Department. Responsibilities include research, reporting, underwriting coordination, and timely claims processing to ensure accurate reporting.

The role requires an Associate degree and 5+ years in healthcare risk/claims administration; a Bachelor's degree or professional designations are preferred. Full-time day shift in the Olathe Medical Pavilion B location.