East Florida Division Claims Administrator

HCA Healthcare • Nashville, TN

103d

About The Position

Do you want to join an organization that invests in you as a East Florida Division Claims Administrator? At HCA Healthcare, you come first. HCA Healthcare has committed up to 300 million in programs to support our incredible team members over the course of three years. This position will be based in East Florida - Ft. Lauderdale, Miami, or Palm Beach. Candidate must reside in this area or be willing to relocate to this area. This position is one of the professional staff positions in the HCI Claims Department and in the larger Risk & Insurance Department reporting to a Director of Claims. As the Division Claims Administrator, you will have broad responsibility for the local coordination of information and document gathering in the course of investigating and defending professional and general liability claims within an assigned territory. This includes supervision of centralized claims staff and is responsible for their facilitation of claims investigation, legal discovery, depositions, mediation, settlement and trials through coordination with Defense Counsel, Investigators, HCI, Facility Patient Safety/Risk Managers, Hospital Administration, Division Leaders, physicians, and patients/families. You will be responsible for directly managing a caseload of the Company's professional liability claims, including in-depth analysis, setting reserves, deciding if a claim should be settled or defended and ultimately bringing that claim to a resolution. You will be responsible for retaining and supervising outside Defense Counsel and regularly interacting with various facility representatives and leaders. You will also assist in identification of claim trends and reinforcement of risk mitigation efforts with clinical leaders throughout their assigned territory.

Requirements

• Bachelor's Degree is required.
• 5+ years of experience in claims management, hospital operations, or risk management role is required.
• 1+ year(s) of experience in hospital acute care nursing role is preferred.
• Florida Adjuster's License (or eligibility to obtain license) is required.
• Licensed Healthcare Risk Manager (LHRM) is preferred.
• Certification in Healthcare Risk Management (CPHRM) is preferred.

Nice To Haves

• Master's Degree (MBA, MPH, MHA, MSH, or JD) is preferred.

Responsibilities

• Engage in the department and company strategy and philosophy of proactive, efficient and effective claims management.
• Manage local claims workflow/processes from the time a probable claim is filed through closure.
• Assure timely collection and accurate recording of all claims related documents.
• Coordinate with HCI Defense Counsel and/or Investigators for release of records and information.
• Assist HCI's claim evaluation process by representing and communicating the local facility's interests.
• Handle professional liability cases with a designated caseload.
• Continuous and appropriate documentation within the electronic claims system for designated caseload.
• Serve as the facility representative in mediations and trials whenever requested.
• Supervise the Division Claims Coordinator; conduct orientation and training, assign work duties, and evaluate performance.
• Coordinate with the PSO and senior leadership regarding potential claims issues.
• Routinely visit assigned hospitals, meeting with patient quality staff to help them focus on risk mitigation efforts.
• Attend hospital and Division meetings as available.
• Maintain performance against department established metrics.
• Develop and maintain positive customer relationships.
• Comply with all relevant state codes, laws, rules and regulations related to the claim coordination responsibilities.

Benefits

• Comprehensive medical coverage that covers many common services at no cost or for a low copay.
• Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans.
• Free counseling services and resources for emotional, physical and financial wellbeing.
• 401(k) Plan with a 100% match on 3% to 9% of pay.
• Employee Stock Purchase Plan with 10% off HCA Healthcare stock.
• Family support through fertility and family building benefits with Progyny and adoption assistance.
• Referral services for child, elder and pet care, home and auto repair, event planning and more.
• Consumer discounts through Abenity and Consumer Discounts.
• Retirement readiness, rollover assistance services and preferred banking partnerships.
• Education assistance (tuition, student loan, certification support, dependent scholarships).
• Colleague recognition program.
• Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence).
• Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Hospitals
• Education Level: Bachelor's degree