Claim Representative
Catholic Health Initiatives - Erlanger, KY

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Job Summary:

This position is responsible for proactively and effectively managing low exposure liability and property claims. This position is also responsible for building and maintaining working relationships with claimants or their attorneys, MBO representatives and internal Risk & Insurance Management staff.

Essential Duties:
  • Proactive investigation, evaluation, strategy development, management and resolution of claims.
    • Directs and collaborates with defense counsel for effective management of litigated claims while controlling defense costs. (liability only)
    • Applies legal and medical principles and statutes to claim facts and allegations in order to determine compensability.
    • Applies insurance policy language to determine coverage and identify issues.
    • Negotiates fair compensation settlements up to authorized authority levels while conserving the assets of CHI.
    • Establish reserves following CHI’s policies and philosophies.
  • Works with MBO Representatives to manage claims and communicate plan of action and exposure assessments to MBO management.
  • Pursues subrogation and excess recovery opportunities.
  • Maintains the integrity of data in claim system and hard files.
  • Identifies loss prevention opportunities and communicates these to MBO and Risk & Insurance Management staff.
  • Handle claims in compliance with state insurance regulations including fair claims handling practices.

Qualifications
Education:

High school diploma or GED required. Bachelor’s degree preferred.

Experience:
  • A minimum of six months experience claims experience preferred.
Additional Responsibilities:
  • Demonstrates a commitment to service, organization values and professionalism through appropriate conduct and demeanor at all times.
  • Adheres to and exhibits our core values:
    Reverence: Having a profound spirit of awe and respect for all creation, shaping relationships to self, to one another and to God and acknowledging that we hold in trust all that has been given to us.
    Integrity: Moral wholeness, soundness, uprightness, honesty and sincerity as a basis of trustworthiness.
    Compassion: Feeling with others, being one with others in their sorrows and joys, rooted in the sense of solidarity as members of the human community.
    Excellence: Outstanding achievement, merit, virtue; continually surpassing standards to achieve/maintain quality.
  • Maintains confidentiality and protects sensitive data at all times.
  • Adheres to organizational and department specific safety standards and guidelines.
  • Works collaboratively and supports efforts of team members.
  • Demonstrates exceptional customer service and interacts effectively with physicians, patients, residents, visitors, staff and the broader health care community.

Catholic Health Initiatives and its organizations are Equal Opportunity Employers. CB

Job
Risk Management
Primary Location KY-Erlanger

Shift 1
Scheduled Hours per 2-week Pay Period 80
Weekends Required None
Status Full Time

Catholic Health Initiatives - 2 years ago - save job
About this company
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For Catholic Health Initiatives (CHI), returning sick people to good health is more than a business -- it's a mission. Formed in 1996...