Liability Claims Specialist

Jackson Health•Miami, FL

23h

About The Position

The Liability Claims Specialist is responsible for claims management functions and as well as providing support to the following departments; Risk, Transfer Center, Regulatory Affairs and Medical Staff office. The Liability Claims Specialist may deal with attorneys in litigation, including labor relations issues. This position works together with other team members to provide high quality and timely support to the work of the organization. This position assists in monitoring, assessing and identifying strategies to improve services, systems and process in the designated area. This position reports to Director of Claims and/or AVP/Chief Patient Safety officer. This position will have a significant role in personnel administration, departmental efficiencies, claims management, and litigation management. This is a project-oriented position with some oversight and works in a confidential capacity. Position requires exercise of independent judgment.

Requirements

Generally requires 0 to 3 years of related experience.
High school diploma is required.
Ability to analyze, organize and prioritize work accurately while meeting multiple deadlines.
Ability to communicate effectively in both oral and written form.
Ability to handle difficult and stressful situations with critical thinking and professional composure.
Ability to understand and follow instructions. Ability to exercise sound and independent judgment.
Knowledge and skill in use of job appropriate technology and software applications.
Paralegal certification or acquire adjuster license within 9 months of hire.

Responsibilities

Create monthly loss runs for open claims out of Quantros.
Regularly draft and send correspondence and legal documents for pending pursuit and litigation which may include grievances related to the subject matter.
Responsible for managing visitor / patient / employee and director appointments.
Oversees bi-weekly Kronos activity for assigned programs and advises AVP when final sheets are complete for approval.
Insurance policy renewal adjunct related to information gathering and interaction with insurance broker.
Prepares accurate Certificates of Insurance as requested from outside contractors.
Review and assign correspondence to appropriate responsible party.
Manages inventory supplies and equipment.
Manages new cases in Quantros related to claims and maintains necessary and relevant content to that new file.
Manages interviews for various claims activities to include depositions, pre-deposition and attendance at trial.
Maintains accurate confidential staff records, including disciplinary records.
Processes and ensures appropriate support information for all check requests.
Constantly manages confidential medical records/files.
Prepares and then transmits Medical malpractice closed claims report to Florida Department of Financial Services on Quarterly basis.
Calendar management for AVP, Senior Directors and Director of Claims as requested.
Prepares AHCA annual report from Quantros system and interacts with Risk leads to ensure complete for submission.
Prepares complex and non-routine letters and maintain efficient correspondence to assist office staff.
Analyzes data for preparing presentations.
Provides primary audit support on annual basis and maintains accurate data for actuarial studies.
Performs all other related job duties as assigned.