Claims Representative - Legal Affairs & Risk Management

NewYork-Presbyterian Hospital

1d • Onsite

About The Position

NewYork-Presbyterian Hospital: Claims Representatives - Make It Possible At NewYork-Presbyterian Hospital, we commit world-class resources to patient care with amazing results. As the healthcare industry rapidly evolves, we depend on our exceptional litigation management team to help us maintain the integrity of our care. We’re saving lives and leading the field of medicine, and now you can help make it possible. Claims Representative - Legal Affairs & Risk Management In this role, you will be responsible for a best practice level of investigation and management of complex healthcare-related professional liability and general liability claims. You'll utilize claims policies and guidelines, review coverage, direct claim investigation, manage outside defense counsel, determine liability and compensability, tender defense, draft detailed evaluations with analysis, secure information and, when appropriate, settle claims. Review, evaluate and analyze information relating to claims, lawsuits and events by reviewing medical records, conducting interviews with hospital staff, and collecting evidence related to claims. You’ll determine exposure and report findings to Associate General Counsel/Director of Claims and Litigation Management; and evaluate, set and maintains reserves within assigned authority levels. Administer the professional and general liability insurance program, review correspondence, meeting with, guiding, and directing outside defense counsel to ensure compliance with the hospitals claims management program. In addition, work independently within specific limits of authority and also collaboratively with supervisors on higher value cases. Join a healthcare system where employee engagement is at an all-time high. Here we foster a culture of respect, belonging, and inclusion. Enjoy comprehensive and competitive benefits that support you and your family in every aspect of life. Start your life-changing journey today. Please note that all roles require on-site presence (variable by role). Therefore, all employees should live within a commutable distance to NYP. NYP will not reimburse for travel expenses. __________________ 2024 “Great Place To Work Certified” 2024 “America’s Best Large Employers” – Forbes 2024 “Best Places to Work in IT” – Computerworld 2023 “Best Employers for Women” – Forbes 2023 “Workplace Well-being Platinum Winner” – Aetna 2023 “America’s Best-In-State Employers” – Forbes “Silver HCM Excellence Award for Learning & Development” – Brandon Hall Group NewYork-Presbyterian Hospital is an equal opportunity employer. It all begins with you. Our amazing compensation packages start with competitive base pay and include recognition for your experience, education, and licensure. Then we add our amazing benefits, countless opportunities for personal and professional growth and a dynamic environment that embraces every person. Join our team and discover where amazing works. Internationally acclaimed, our hospital leads the way in research, life-shaping education and compassionate care. Step into a career at a truly Amazing place. Among the highest echelon of the topmost hospitals in the world, NewYork-Presbyterian is Making It Possible for patients at this moment. What does this mean for you? Nothing less than an extraordinary career. We care for 1 out of every 4 New Yorkers in medical need. The nation's largest not-for-profit academic medical center, with over 2 million patient visits a year.

Requirements

• Bachelor’s degree
• Three to five years clinical experience or insurance industry claims management

Nice To Haves

• Bachelors of Science in Nursing or other clinical degree with previous clinical experience
• General liability insurance industry claims management experience

Responsibilities

• Responsible for a best practice level of investigation and management of complex healthcare-related professional liability and general liability claims.
• Utilize claims policies and guidelines, review coverage, direct claim investigation, manage outside defense counsel, determine liability and compensability, tender defense, draft detailed evaluations with analysis, secure information and, when appropriate, settle claims.
• Review, evaluate and analyze information relating to claims, lawsuits and events by reviewing medical records, conducting interviews with hospital staff, and collecting evidence related to claims.
• Determine exposure and report findings to Associate General Counsel/Director of Claims and Litigation Management
• Evaluate, set and maintains reserves within assigned authority levels.
• Administer the professional and general liability insurance program, review correspondence, meeting with, guiding, and directing outside defense counsel to ensure compliance with the hospitals claims management program.
• Work independently within specific limits of authority and also collaboratively with supervisors on higher value cases.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level