Risk Control Consultant
CNA Insurance
Senior Claims Manager – Risk and Insurance
Bon Secours Mercy Health
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteJob Level
Senior
About the role
- Effectively and efficiently manages liability claims, including hospital and employed physician claims
- Represents BSMH at pre-trial hearings, mediations, arbitrations and trials
- Manages and directs defense counsel in accordance with organizational objectives and goals
- Independently evaluates and resolves matters up to the position’s captive program settlement authority limit of $50,000.00
- Handles matters up to $500,000.00 in total exposure
- Utilizes risk investigations and expert reviews to evaluate legal liability and causation to set financial reserves
- Assigns appropriate defense counsel depending on venue, claim type, and potential claim value
- Works extensively with outside defense counsel to manage and resolve claims
- Conducts appropriate insurance coverage analysis for various lines of coverage on each liability claim
- Works closely with Loss Prevention to identify potential claims that would qualify for the Early Liability Review Program
- Maintains a diary system to track claim progression from report through investigation, evaluation, discovery, and analysis
- Responsible for obtaining defense counsel reports in a timely manner and directing litigation efforts according to department guidelines
Requirements
- Bachelors degree required
- MBA or JD preferred
- CPCU, ARM, SCLA, AIC, CCP preferred
- 7 years handling Professional Liability Claims or equivalent experience
- 10-12 years’ experience in a personal or commercial lines liability claims department preferred
- Working with claims databases
- Attention to detail
- Working with word processing platforms
- Acceptance of authority
- Working with Excel Spreadsheets
- Critical thinking
- Contract Analysis
- Communication with patient, family, or representatives
- Time Management
- Negotiation
- Self-motivated
- Overcoming objections
- Recommend and set financial reserves
- Investigation and evaluation
- Evaluate liability exposure values
- Making presentations to ministry leadership
- Interpreting medical records
- Building rapport
Benefits
- Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible)
- Medical, dental, vision, prescription coverage, HSA/FSA options, life insurances, mental health resources and discounts
- Paid time off, parental and FMLA leave, shot- and long-term disability, backup care for children and elders
- Tuition assistance, professional development and continuing education support
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
liability claims managementinsurance coverage analysiscontract analysisfinancial reserves recommendationrisk investigationsevaluation of legal liabilityclaims database managementmedical records interpretationnegotiationclaims resolution
Soft skills
attention to detailcritical thinkingtime managementself-motivatedcommunicationbuilding rapportacceptance of authorityovercoming objectionspresentation skillsorganizational skills
Certifications
Bachelors degreeMBAJDCPCUARMSCLAAICCCP
