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Carrot Peelers, Sales, Personality and Your Job Search
In-House
Legal Staff
Insurance
Min 5 yrs required
Claims Administrator The candidate will provide services to the business operations of Advocate Insurance SPC (AISPC) in conjunction with system-wide Claims Management, Risk Management, Risk Financing and Insurance Programs. Day to day management and oversight of specific assigned claims. Performing high-level work assignments, managing discovery, legal analysis, claim valuations and on-going assessments through either resolution or trial of assigned cases. Responsible for the evaluation of site specific insurance loss runs and must establish and maintain a working relationship with the site(s) Risk Management personnel to identify, investigate, manage and resolve claims with a focus on loss mitigation and prevention strategies and reducing liability exposure for Advocate. Interaction and sharing of information is essential to maintain a proactive risk management and insurance program. Manage to resolution and closure assigned professional and general liability claims, This includes the following: non~asserted, asserted direct patient claims, attorney liens and lawsuits against all Advocate facilities and/or contracted, employed health care providers covered under our AISPC programs. The Claims Administrator is responsible for thoroughly investigating the insurance coverage applicable to the claim and in accordance with established criteria. With respect to litigation being handled by outside defense counsel, this individual is responsible for the day to day management of counsel as well as the claim as it progresses through the legal system. Establish and meet KRA strategic goals for the position and in alignment with departmental and Company goals. Once identified, negotiate and resolve by way of settlement, assigned asserted claims, attorney liens and lawsuits up to designated authorization limit, or such amounts as authorized by the supervisor or as approved by the Claims Review Committee. Direct negotiation with plaintiff's attorneys, defense counsel, judges, mediators, claimants and patients and/or their family members or designated representative, when applicable. Serve as AISPC's official representative at site meetings, mediations, pre-trials and trials, present the Company's position on pre~litigated or litigated matters including the responsibility of presenting and negotiating financial settlement authority as directed for the Company. Responsible for preparing narrative and/or summary reports, financial reports and maintaining and providing reports.
Qualification and Experience
Qualifications: Bachelor's Degree or equivalent experience. 5 years of claims, risk management or law firm paralegal experience, preferably concentrated in the practice area of medical and professional negligence. 6+ years in health care environment, insurance, legal, risk management. Knowledge of claims and risk management and related insurance, specific to general and professional liability. Requires excellent critical thinking and project management skills, as well as proven ability to work with site team risk management staff and manage to a successful result the efforts and activities of the system-wide site risk management team, outside counsel and patients and their family members. Will be required to work with minimal oversight and must be able to make competent decisions affecting risk management, insurance, claims, legal, and senior and executive leadership and other internal and external business partners under the supervision of the Claims Directors.
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