Overview
RN Claims Specialist – Risk Finance Jobs in Tyler, Texas, USA at Christus Health
A CHRISTUS Regional Claims Specialist represents CHRISTUS Health and its facilities and providers and provides support to the Vice President of Litigation, the other Regional Claims Specialist and the Claims Team in the investigation, management, resolution and defense of claims, appeals, arbitrations or any other form of disputes. The duties vary including support of matters in pre-litigation and active litigation.
Other legal work involves management of subpoenas, court appearances, mediations and trial appearances. Travel is a requirement (25-30%). Serves as liaison to all affiliated health care centers in the investigation, resolution and defense of claims.
Provides support to the Vice President of Litigation, other Clinical Regional Claims Mangers and the Claims Team in the investigation, management, resolution and defense of liability events, claims, appeals, arbitrations or any other form of disputes.
Evaluates and investigates patient and claimant complaints and demands and communicate recommendations for handling. Prepares privileged work product reports containing with clinical analysis regarding same and provides recommendations to the team for handling.
When appropriate, negotiates settlements within designated authority, prepare settlement agreements using language of settlement agreements approved by the CHRISTUS Vice President of Litigation.
Analysis of MMSEA issues.
Identifies and evaluates trend and report analysis of quality and risk issues to assist in reducing the frequency of preventable adverse occurrences. Prepares presentations to facility
leadership
concerning trends and recommendations for improvement.
Investigates all assigned Events, UPLE, Injured Asserts, Attorney Asserts, Medical Review Panels and Suits.
Retains oversight of defense of claims interacting with defense counsel and defense teams.
Provides liability analysis and investigative support to defense counsel on commencement of litigation.
Prepares status reports or other presentations relative to active claims based on regional assignments.
Monitors trials, mock trials, jury studies and depositions and provides analysis and recommendations regarding litigation management to the CHRISTUS Vice President of Litigation.
Monitors Outside Counsel compliance with guidelines and billing requirements.
Interacts regularly with external attorneys related to the oversight and management of claims and all matters in litigation.
Coordinates, Plans and Participates in facility claims reviews.
Participates in Teaching events across the system as needed including teaching nursing residents on matters related to legal claims.
Participates in risk management surveys of facilities.
Must have computer literacy, PowerPoint /Excel skills a plus.
Three to Five years in a health care setting with exposure to some combination of clinical care, risk management or operations.
~Some legal experience (i. e., Paralegal, Legal Nurse Consultant) Preferred. Use the red Application button below to Read More / Continue the application process.
Title: RN Claims Specialist – Risk Finance
Company: Christus Health
Location: Tyler, Texas, USA
Category: Management, Law/Legal
