Overview
RN Claims Specialist – Risk Finance Jobs in Irving, Texas, USA at Christus Health
Description
Summary:
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.
Responsibilities:
Meets expectations of the applicable OneCHRISTUS
Competencies:
Leader of Self, Leader of Others, or Leader of Leaders.
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. Investigation includes, at times, on site interviewing of providers.
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.
Attends depositions, trials, hearings (as needed) and mediations. Negotiates negotiate settlements at mediation or directly with claimant or plaintiff’s counsel within designated authority. Drafts settlement agreements. 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.
Recommends reserves and adjustments to same indicated by any follow-up investigation.
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.
Use the red Application button below to Read More / Continue the application process.
Title: RN Claims Specialist – Risk Finance
Company: Christus Health
Location: Irving, Texas, USA
Category: Management, Law/Legal
