Claims Representative - Make It Possible
At NewYork-Presbyterian Hospital, we commit world-class resources to patient care with amazing results. As the healthcare industry rapidly evolves, we depend on our exceptional litigation management team to help us maintain the integrity of our care. We're saving lives and leading the field of medicine, and now you can help make it possible.
We are currently seeking a dynamic and highly knowledgeable Claims Representative to join our team at NYP. In this position, you will be responsible for the overall management of healthcare-related professional liability and associated general liability claims. Your knowledge of claims policies and guidelines will be crucial as you review coverage; direct claims investigations; monitor and control activities of outside defense counsel; determine liability and compensability; secure information; and negotiate and settle claims directly with plaintiff counsel. This position also:
Qualified candidates must have a bachelor's degree or equivalent experience, and three to five years' experience in insurance industry claims management (or comparable clinical hospital experience). Preferred candidates will have professional designations and demonstrate technical expertise and product-specific knowledge. Medical malpractice claims management experience or a clinical background is preferred but not required.
- Evaluates suspected high-risk cases; identifies potential liability; determines exposure and reports findings to Associate General Counsel/Director of Claims and Litigation Management; and evaluates, sets and maintains reserves within assigned authority levels.
- Facilitates effective communication with hospital administration, professional and ancillary staff and outside legal counsel in order to assist in the defense of cases, which includes the preparation of cases for trials.
- Provides hospital counseling to help administrate the professional and general liability insurance program; reviews correspondence; and meets with, guides and directs outside defense counsel to ensure compliance with the hospital's risk management program.
- Engages in settlement negotiations with plaintiffs' attorneys within assigned authority levels; directs further action regarding litigation, settlements or appeals; and directs the use of surveillance, outside expert opinions and physical examinations.
#1 in New York. #7 in the Nation. - U.S.News & World Report, "America's Best Hospitals 2012 - 2013"
Discover why we're #1 in New York - an unparalleled pursuit of excellence in patient care and the widest array of choices for your career. We're inviting the best professionals to work side-by-side to lead the way.
We are an equal opportunity employer.
- 2 years ago - save job