The Corporate Claims Manager mitigates the organization's exposure to risk by managing the coordination of claims for general liability and professional liability. Responsible for securing legal services and working with attorneys, insurance company representatives, and facility Risk Managers to develop an action plan to respond to claims.ESSENTIAL FUNCTIONSReviews and analyzes all claims and lawsuits for general liability and professional liability programs and opens claims in the RMIS system. Manages the work flow through closure.Responsible for review of incidents and coordination of investigations with defense counsel and facility Risk Managers.Assigns legal counsel from Acadia panel of attorneys and is their primary contact in the daily management of the case. Works with Director of Insurance/Claims to review claims/lawsuits and develop resolution strategies to discuss with legal counsel.Contact facility CEO and Risk Manager to notify them of assignment of counsel, discuss incident and prepare Risk Manager for possible liaison with defense counsel. Update Trial and Mediation log when a trial date and/or mediation date is scheduled.Prepare Summary of Legal Claims with updated claims and lawsuit information for review and discussion with Director of Insurance/Claims and Chief Risk Officer.Discuss updated potential claim information with Director of Risk, Director of Insurance/Claims and Chief Risk Officer.Review reserves of claims/lawsuits with Director of Insurance/Claims and Chief Risk Officer to adequately evaluate the cost of case until closure.OTHER FUNCTIONS:
- Performs other duties as assigned
- Complies with organizational policies, procedures, performance improvement initiatives and maintains organizational and industry policies regarding confidentiality.
- Communicate clearly and effectively to person(s) receiving services and their family members, guests and other members of the health care team.
- Develops constructive and cooperative working relationships with others and maintains them over time.
- Encourages and builds mutual trust, respect and cooperation among team members.
- Maintains regular and predictable attendance.
- Bachelor's degree or equivalent work experience.
- Minimum 2-3 years in insurance management.
- Advanced computer skills including Microsoft Office; especially Word, Excel, and PowerPoint.
- Knowledge of office administration procedures with the ability to operate most standard office equipment.
- Ability to work professionally with sensitive, proprietary data & information while maintaining confidentiality.
- Excellent interpersonal skills including the ability to interact effectively and professionally with individuals at all levels; both internal and external.
- Exercises sound judgment in responding to inquiries; understands when to route inquiries to next level.
- Self-motivated with strong organizational skills and superior attention to detail.
- Must be able to manage multiple tasks/projects simultaneously within inflexible time frames. Ability to adapt to frequent priority changes.
- Capable of working within established policies, procedures and practices prescribed by the organization.
- English sufficient to provide and receive instructions/directions.
- PREFERRED: Adjuster's License
This position is an Individual Contributor