Senior Claims Attorney

University of Florida•Gainesville, FL

About The Position

This position is responsible to the Deputy Administrator and involves the intake, processing, and disposition of all incidents reported and/or referred to the Self-Insurance Program (SIP). The role includes identifying, investigating, analyzing, and evaluating medical, legal, and fiscal issues related to covered claims against SIP participants. Responsibilities also encompass coordinating, managing, and resolving claims through denial, settlement, or defense, including executing presuit legal and administrative processes required by Florida Statute. The Senior Claims Attorney will coordinate and manage litigation processes, identify risk factors contributing to claims and suits, and collaborate with SIP’s Loss Prevention staff to mitigate identified risks. Extensive travel is required for meetings and depositions across the United States and occasionally in foreign countries. The role also provides investigative and administrative support for healthcare providers facing administrative proceedings related to their licenses and facilitates the procurement of legal counsel. Attorneys licensed in Florida may prepare witnesses for unsworn statements, represent covered entities at unsworn statements and depositions with prior approval, and perform various legal tasks such as preparing memos of law, legal responses, and conducting legal research.

Requirements

Law degree (L.L.B. or J.D.)
Three years of experience in the legal, medical, or health care fields.

Nice To Haves

Knowledge of tort law
Knowledge of health care systems
Knowledge of risk management techniques
Medical malpractice claims handling experience
Ability to perform under great pressure in a multi-tasking environment
Demonstrated competency in medical research
Demonstrated competency in internet research skills
Excellent oral and written communication skills
Good native intelligence
Ability to interact with individuals of all social and economic backgrounds

Responsibilities

The intake, processing, and disposition of all incidents report and/or referred to the Self-Insurance Program
The identification, investigation, analysis and evaluation of the medical, legal, and fiscal issues related to covered claims, potential or asserted, against Participants of SIP
The coordination, management and resolution, including denial, settlement or defense of all covered claims with or without Notice of Intent, potential or assert, against SIP participants, including the coordination, management and execution of all presuit legal and administrative process required by Florida Statute
The coordination and management of litigation processes in defense of lawsuits filed based on covered claims
The identification of risk factors which cause or contribute to claims and suits
The coordination of effort with the SIP’s Loss Prevention staff to mitigate or remove identified risk factors
Ensure all reported incidents are reviewed and evaluated for patient care and health care delivery improvement opportunities and for potential claims falling under the purview of the SIP.
Take incidents reports on a direct access basis, ensuring that reported incidents are promptly and accurately recorded in the Riskonnect database.
Perform all interviews, records reviews, and information analysis necessary to determine the chronology of events and resultant outcomes of an incident.
Ensure that appropriate administration at SIP is timely notified of significant incidents.
Conduct a full factual investigation of assigned claim files.
Evaluate claims in terms of negligence, causation, and compensable damages.
Present initial claims summaries to SIP internal committees.
Prepare claim summaries and make indemnity and allocated loss expense reserve recommendations pursuant to established protocols.
Serve as advisor to and investigator for the Self-Insurance Program Council and its Claims and Litigation Committee.
Provide assistance as required in fulfilling SIP administrative responsibilities, including the presentation of claims summaries and related reports.
Undertake a full factual investigation and timely response to assigned claims, asserted and potential.
Prepare timely appropriate responses to presuit information requests and production.
Track the progress of all assigned cases in presuit to ensure that appropriate responses, negotiations and settlement offers, or alternatively, denials and aggressive proactive defense are accomplished for the timely resolution of claims, as required by Florida Statute and policy set by SIP Management.
Initiate the employment and retention of experts.
Undertake the preparation of witnesses and participate in unsworn statements and other presuit discovery.
Monitor files to ensure appropriate reserves are in place and allocated loss expense and indemnity payments remain within authorized limits.
Monitor and continue the full factual investigation of asserted claims through litigation.
Coordinate and ensure timely response to interrogatories and production.
Track the progress of assigned all cases in litigation to ensure that an aggressive proactive defense and resolution of claims is accomplished within the timeframe set by SIP Management.
Assist in the selection of outside legal counsel and participate at all significant hearings, depositions, mediations, and trials.
Coordinate and ensure that assigned files are reviewed and analyzed for potential loss prevention activities and that assigned files contain appropriate documentation pertaining to loss prevention and risk reduction initiatives associated with the claim.
Collaborate directly with the SIP Loss Prevention staff to identify potential risk and opportunities for loss reduction, recommending activities to mitigate or remove identified risk factors, and assisting in follow-up on loss prevention programs.
Provide advise and assistance on an immediate access basis regarding patient care liabilities and protocols related to loss prevention.
Conduct in-service education programs, seminars, and topical presentations for faculty physicians, residents, nurses, or other healthcare providers.
Develop loss prevention awareness through regular interaction with healthcare providers.
Demonstrate the benefits of established loss prevention programs and successful effort resulting from the proactive management of potential risks.
Prepare witnesses employed or formerly employed by covered entities for unsworn statements in presuit discovery.
Represent covered entities at unsworn statements and depositions, in those situations and circumstances where prior approval has been obtained.
Perform a variety of legal work, including but not limited to, the preparation of memos of law, the preparation of legal responses, the preparation of witnesses before trial and the conduction of legal research.