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Careers At Healthcare Risk Advisors

Professional Liability Investigator

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

Healthcare Risk Advisors has an exciting Professional Liability Investigator position available in their NYC office! 

The Investigator serves as the primary investigator of lawsuits and occurrences at the institutions insured through HRA's Insurance Program. In addition, the investigator also participates in committee meetings, risk management education programs and claim review activities. The Professional Liability Investigator assists in the defense of medical malpractice lawsuits and claim management, and identifies issues that may have an impact on the quality of care at insured institutions. 

ESSENTIAL DUTIES & RESPONSIBILITIES:

  1. Investigates letters of claim and potential high exposure alerts; reviews and summarizes medical records, interviews involved parties and generates investigation reports that cover all key issues and / or allegations. Conducts summons reviews, including witness identification, on all hospital-based summonses.
  2. Reviews and integrates relevant information from the legal file and documents into the investigation process.
  3. Prepares, types, and submits investigation reports to the Investigative Coordinator for finalization and distribution according to department protocol.
  4. Provides information on occurrences, issues, and findings to Manager, Professional Liability Investigation, claim examiner and hospital Risk Manager.
  5. Accurately documents investigative findings in Oasis claim system. Updates appropriate fields in OASIS following investigation, including the clinical risk management database.
  6. Following investigation of a case, the PLI ensures the IA has appropriately requested the security of evidence.
  7. Attends in-house and client meetings as required.
  8. When the IA is not available, opens unasserted cases (alerts and ARLs) on the OASIS claim system and requests security of appropriate documents and items relevant to the defense of cases according to specified procedures.
  9. Reviews defense attorney correspondence as necessary; responds to defense counsel or claim examiner/ attorney investigation requests for hospital records and/or policies, obtains/provides relevant medical evidence when the Investigative Associate (IA) is not available, and conducts relevant interviews upon request by defense counsel, risk manager or claim examiner.
  10. Uploads all medical records of assigned cases into OnBase.
  11. Participates in PLI orientation program, as requested.
  12. Performs other duties or special projects as required or as assigned.

PERFORMANCE METRICS:

  •  Investigates at least 10 cases per quarter.
  •  Finalizes investigation reports within 2 weeks of submission, and updates OASIS within 7 days following investigation report finalization.
  •  Completes summons reviews within 30 days of assignment.
  •  Achieves a PLI Quality Assurance rating of at least 3 on investigation reports.
  •  In the absence of the IA, the PLI opens unasserted cases, completes applicable fields in Oasis and requests security of relevant evidence within 30 days of assignment.

QUALIFICATIONS AND REQUIREMENTS:

Education/Certification

  •  AA/BA/BS degree. RN, PA, or healthcare related license required.      

 Experience Required

  •  3-5 years of clinical experience.

  Skills/Abilities:

  •  Demonstrated knowledge of medicine required.
  •  Excellent interpersonal and communication skills.
  •  Strong writing skills.
  •  Basic Microsoft Office Suite skills.
  •  Ability to work independently and be flexible.
  •  Ability to multi-task.
  •  Ability to travel within the tri-state area.


Healthcare Risk Advisors, Inc., formerly FOJP Service Corporation, provides comprehensive insurance and risk management advisory services to leading academic hospitals, long-term care facilities, and social services agencies in the metropolitan New York area.

Healthcare Risk Advisors employs a best-in-class approach to risk management that includes risk transfer, development of favorable insuring terms, and dedicated client services throughout the entire claims process. Our team includes accomplished insurance and brokerage professionals as well as attorneys with extensive experience in claims litigation, insurance, and contract law.

HRA’s goal is to ensure that our clients have appropriate levels of coverage—as well as access to risk prevention services and resources—so they can focus their time and effort on the communities they serve.

HRA offers countless career opportunities and an environment which fosters professional advancement and success. Visit www.healthcareriskadvisors.com  to learn more about our company.


HRA is an equal opportunity employer. 

  

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