Professional Liability Medical Claims Manager

Professional Liability Claims Manager | AdventHealth Corporate

Location Address: 900 Hope Way, Altamonte Springs, Florida 32714

Top Reasons to Work at AdventHealth Corporate

• Great benefits
• Immediate Health Insurance Coverage
• Career growth and advancement potential

• Full-Time, Monday â“ Friday

You Will Be Responsible For:

• Manages complex professional and general liability claims in multiple jurisdictions which could require travel to healthcare facilities, depositions, mediations and trials.
• Manages the day-to-day claim development by directing and coordinating investigations, determining legal liability and assessing damages.
• Must be able to create and maintain an effective diary management system to ensure all claims are given the appropriate attention.
• Sets, maintains and justifies appropriate reserves taking in consideration the projection of claim payments and verdicts in the jurisdiction.
• Navigates the claims process by determining liability, causation and damages and negotiating resolution or positioning matters for trial.
• Controls and directs counselâ™s litigation activities which includes case strategy, settlement negotiations and/or trial preparation.
• Have knowledge of coverage limits and carriers for applicable line of business
• Timely reports cases to carriers whether Trust, Excess or Re-insurer as documented in RiskMaster.
• Directs and coordinates investigation to determine legal liability at facility level and documents findings.
• Effectively involves local risk managers in the investigation process and ensures CEO (or designee) is informed throughout the development of the case.        
• Documents in the claim file investigation information, coverage determination, liability exposure, case value and management strategy relating to decisions of defense and resolution.

• Bachelorâ™s degree with additional study and or professional designation preferred. Nursing, Business Administration, insurance claims management, sociology, psychology, or human behavior studies background beneficial.
• 3-5 years of experience
• RiskMaster, MS Word, MS Excel
• Florida all-lines adjusters license

This position is responsible for the management of assigned potential compensable claims, asserted claims and suits.  Management encompasses investigation, evaluation, negotiation and settlement activities, attorney supervision and trial support.  This position is responsible for handling professional and general liability claims and knowing the relevant case law in multiple jurisdictions as assigned.