- Manage claims and litigation for hospital members, insured physicians and physician groups
- Presuit evaluation of claims including investigation, medical record review, liability analysis, expert retention and discussion with insureds and clients
- Retention and supervision of outside defense counsel for claims in litigation
- Responsible for case strategy and implementation and oversight of case action plan in collaboration with defense counsel
- Analyze claim submissions from clients and establish and maintain claim files and reserves
- Notification to excess/reinsurers as required and discuss claims as requested
- Evaluation of excess and captive layers including monitoring of aggregate erosion
- Negotiate settlements with claimants, families or attorneys as appropriate and within prescribed authority levels
- Evaluation of defense counsel bills and authorize invoices or settlement check requests for payment
- Communicate with AVP regarding loss reserve increases, large losses, adverse claim development, and status of litigation and trials
- Prepare and present claims at quarterly reviews and for roundtable discussions with staff Prepare and present claims to Claims Committee or Board as required for settlement authority
- Attend self-insured clients' board, committee or claim meetings as requested
- Attend pre-trials, mediations or trials as required
- Prepare reports for MMSEA, Illinois Department of Insurance, Illinois Department of Financial and Professional Regulation and the National Practitioner Data Bank
- Prepare for and participate in client board, committee or claim meetings as requested Prepare and present educational presentations for risk management meetings and/or for clients as requested
- Assist AVP with contract and subpoena reviews
- Provide guidance and direction to claims consultants Collaborate with risk management and underwriting staff regarding claim trends and renewal issues
- Responsibilities may include assignment to manage and coordinate all claims reporting required by the Medicare, Medicaid and SCHIP Extension Act of 2007 (MMSEA, Section 111), including education of staff and clients, registration, testing, monthly queries and reporting
- May be called upon to provide back-up support in the AVP's absence for EPCS and Acuity approvals
- Other duties as defined
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Senior Claims and Litigation Supervisor, Medical Malpractice - Naperville, United States - Illinois Health and Hospital Association
Description
Main Function:
Responsible for the management of professional and general liability claims and litigation for member hospitals and insured physicians. Management of large hospital accounts and/or self-insured accounts requiring a high level of expertise and independence.
Outline of Responsibilities:
Qualifications:
Bachelor's Degree and at least 5 years of prior claims or litigation experience required. Juris Doctor with medical malpractice litigation experience preferred. Knowledge of Illinois law and insurance principles a plus. Proficient in Microsoft Office Suite. Excellent verbal and written communication skills required. Must possess and exercise analytical and critical thinking skills and be a team player who can manage multiple projects. Routine travel within Illinois is required.
