Claims Analyst or Claims & Patient Safety Specialist

MIEC•Oakland, CA

26d•$73,050 - $149,484•Remote

About The Position

Are you ready to make a real difference in healthcare? MIEC is searching for a dynamic Claims professional to join our passionate team and play a pivotal role in protecting medical professionals and advancing patient safety! Whether you step into the role of Claims Analyst or take on the expanded responsibilities of Claims & Patient Safety Specialist, you’ll be at the heart of our mission—opening, investigating, managing, and resolving incident and claim files for our valued policyholders. But that’s just the beginning! As an Analyst or Specialist in our Claims Department, you’ll go beyond claims management, partnering directly with groups and individual policyholders to deliver innovative Patient Safety & Risk Management services. You’ll help shape safer healthcare environments, drive impactful change, and become a trusted advisor to those who count on us most. Join MIEC and be part of a team that’s redefining excellence in claims and patient safety—where your expertise, initiative, and commitment truly matter.

Requirements

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.
An understanding of clinical systems.
Knowledge of hospital policies and procedures, and governmental healthcare regulations.
Ability to analyze medical records and quality issues.
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.
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.

Nice To Haves

A Certified Professional in Healthcare Risk Management (CPHRM) designation is preferred.

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.