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MIEC · 1 month ago

Claims Analyst or Claims & Patient Safety Specialist

United States

Full-time

Remote

Mid, Senior Level

$73K/yr - $149K/yr

5+ years exp

MIEC is a physician-owned medical professional liability insurer seeking a dynamic Claims professional to join their team. The role involves managing claims, collaborating with policyholders, and delivering innovative Patient Safety & Risk Management services to enhance healthcare safety and quality.

Customer ServiceFinancial ServicesHealth CareInsuranceMedical

Responsibilities

Respond to first notice of potential claims from policyholders and handle advice calls, gathering preliminary information and providing appropriate advice for action

Collaborate with the Claims team to identify and evaluate insurance coverage issues, and to develop, prepare and implement appropriate negotiation/case resolution strategies

Obtain and review records, interrogatories, depositions, consultant reports, and attorney reports; coordinate discovery with defense counsel; monitor file status, reserves, legal landmarks and billings

Prepare documentation, reports, and correspondence with policyholders, claimants and attorneys

Submit incident, claim and suit files for opening; manage and close files in a timely manner

Exercise strong judgment in settling cases within authority and develop indemnity and expense reserve recommendations above defined authority level

Study trends and current developments within the medical malpractice industry in the states in which MIEC operates, and nationally. Proactively share information within the department about the trends and current developments, including relevant court cases

Participate in seminars, trainings, meetings, and Board meetings, when requested

Collaborate with MIEC’s Patient Safety & Risk Management (PSRM) staff to provide specialized internal and external services addressing existing member groups and new business, including large medical groups and hospitals

Apply principles of healthcare risk management, such as incident reporting and investigation, risk analyses, and policies/procedures, to further develop PSRM services which can be applied in all healthcare settings

Collect, analyze, and compare MIEC data to present evidence-based information to members, utilizing data from various healthcare and medical malpractice claims sources including Candello - Solutions by CRICO, the MPL Association Data Sharing Project, and Preverity

Coordinate and conduct Claims Prevention Surveys for policyholders

Manage active matters involving unanticipated patient harm through MIEC’s RESTORE communication and resolution program; work with MIEC policyholders to support effective patient communication, disclosure, and/or apology discussions

Effectively research, write, and edit patient safety and risk management articles, newsletters, and other written materials

Participate in the conception and completion of special projects

Qualification

Medical malpractice claimsPatient Safety Risk ManagementData analysisHealthcare regulationsClinical systemsCommunication skillsCustomer service focusResearch skillsDigital fluencyOffice software proficiencyAttention to detailTeam collaborationWritten communicationVerbal communicationInterpersonal skillsTime management

Required

A Bachelor's degree (BA/BS) is required

A valid driver's license is required

The ideal Claims & Patient Safety Specialist candidate will join us with a minimum of seven (7) years of experience as a medical professional liability claims representative, risk manager or similar experience in defense of medical professional liability or risk management/patient safety field required

The ideal Claims Analyst candidate will join us with a minimum of five (5) years of experience handling medical professional liability claims or professional-level experience in the legal industry

An experienced team member with a demonstrated expertise in the handling of medical malpractice claims and a solid understanding of Patient Safety Risk Management (PSRM) services and products, and the ability to address general PSRM questions or refer to the appropriate discipline

A flexible collaborator who has a demonstrated customer service focus with all levels of internal and external stakeholders

An enthusiastic and self-directed contributor who is skilled at managing multiple priorities with great attention to detail, within time-sensitive deadlines

An inquisitive analytical thinker with good judgement, professional initiative, and strong research skills

An excellent communicator, with strong written, verbal, and interpersonal communication skills and ideally with proficiency in medical terminology

Digital Skillsets: Our ideal candidate will be a digitally fluent contributor, comfortable in a range of virtual environments and proficient with office software including Word, Excel, Power Point, Windows, Teams, Sharepoint, CoPilot, and paperless document management programs