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Careers At Healthcare Risk Advisors

Medical Malpractice Claim Professional and Analyst

Department: Claim
Location: New York, NY
Company: HRA

Healthcare Risk Advisors has an exciting Medical Malpractice Claim Professional & Analyst position available. 

The Medical Malpractice Claim Professional & Analyst handles professional liability claims identified and assigned by the AVP, Staff Development in conjunction with the Directors/AVPs of the teams. In addition, the position would have a broad range of responsibilities, including training and supervising of new hires, acting as a liaison to the hospitals, providing the AVP of Staff Development with much needed support on special projects, and affording support across all of the internal Claims pillars.

  

ESSENTIAL RESPONSIBILITIES:

  1. Manage professional liability matters, which would include a smaller pending case size (50-75 cases).   These cases would be assigned or transferred from other CAs at the discretion of the AVP. 
  • Assigns counsel to defend lawsuits. Works with counsel to develop the litigation strategy. Reviews, analyzes and documents defense counsel correspondence and expert reviews. Coordinates investigation of claims and lawsuits. Monitors trial/case developments and communicates with carriers and hospital representatives. Responds to carrier inquires.
  • Conducts regularly scheduled claim conferences with carrier, hospital representatives and defense counsel to develop defense/settlement strategies and obtain settlement authority.
  • Provides written and oral communication to insureds regarding commencement, settlement and/or disposition of lawsuits.
  • Evaluates and coordinates resolution of insurance coverage issues and overlapping insurance coverage situations.
  • Analyzes and quantifies damages. Establishes reserves for future claim management.
  • Negotiates settlements with claimants or attorneys.
  • Directs assignment of medical expert witnesses.
  • Evaluates sufficiency of settlement documents and directs settlement payments.
  • Oversees routine claims administration (openings, closings, NPDB reporting) and approves provider bills/expenses.
  • Accurately documents all actions in Oasis claim system.

   2.  Training of new hires and ongoing departmental training in Best Practices and other areas deemed necessary.

  3. Floater capacity for trials, leaves of absence, and equalization of workflow across the teams

  4. Interface and attend committee meetings with other departments.

  5. Act as an additional liaison and point of contact with hospital risk managers and VAPs

  6. Assist or direct special projects for insureds and internal clients.

  7. Performs other duties or special projects as required or as assigned.

PERFORMANCE METRICS:

  •  Correctly and accurately evaluates liability and damages and sets appropriate reserves for 100% of assigned claims. Ensures reserve increase notes appropriately address liability and damage issues for 100% of assigned cases.
  •  Maintains accurate Oasis claims data and meaningful diaries for 100% of assigned claims.
  •  Monitors defense counsel activities and litigation costs.
  •  Completes all assigned projects timely

QUALIFICATIONS AND REQUIREMENTS:

 Education/Certification:           

  •  BA/BS degree with JD preferred.

                                         

Experience:                             

  •  5 years medical malpractice defense experience.
  •  5 years professional liability claims and claims management experience preferred.

 

 Skills/Abilities:                        

  •  Excellent interpersonal and organizational skills.
  •  Good knowledge of medical malpractice law. 
  •  Good listening skills.
  •  Good negotiating skills.
  •  Good Microsoft Office Suite skills.
  •  Computer proficient

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