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Director of Claims
at Medicus Insurance Co in Texas
Claims Manager/Director with proven track record building and managing world class claims organization. Possess expertise in technical claims management for Medical Professional Liability Insurance with a focus on the Physician and Surgeon market. Effectively aligns claims, underwriting and operations to develop increased efficiencies, reduce loss costs and enhance profitability. Proven team leader in small-scale claims organizations in a high growth mode. Skill set to handle individual claims management and claims portfolio management, and supervise and collaborate with third party claims administrator with a keen focus on the company claims management philosophy.
Responsibilities:
• Re-engineering claims process, as required, in company specialty line
• Perform day-to-day management and periodic quality review audits on malpractice claims with third party claims management vendor
• Work with Actuarial, Finance company management to set reserving standards
• Working with claims vendor, manage all aspects of litigation from discovery through trial in the defense of physicians in claims alleging malpractice,
• Develop and manage relationships with claims vendor and staff, Attorneys, Investigators and Field Adjusting companies across the multiple state markets of operation
• Review and recommend performance metrics and cost savings in company claim operation.
• Investigate and implement, as required, automated solutions for electronic claims records, claims financials, and analytical reporting tools with Finance
• Recruit claims professional/staff, when required, to build an in-house claims operation.
• Increased business unit performance by driving implementation of best claims practices.
Requirements:
• Keen understanding of efficiently adjudicating medical professional liability insurance claims in many states, as well as current health care market, tracking the changes in legislation and tort reforms.
• 10 years of experience in the insurance industry, with proven results specializing in medical professional liability insurance claims, loss prevention, and risk management.
• Bachelors degree required, licensed Health Care Risk Manager and Master Degree preferred. Law degree highly desired.
• Expertise in developing and enhancing Information Technology related to claims management systems.
• Keen relationship-building skills with ability to bring a high energy level to the management team.
• Strong belief and skills in customer service and diplomacy with ability to manage multiple staff at off-site third party vendor.
Responsibilities:
• Re-engineering claims process, as required, in company specialty line
• Perform day-to-day management and periodic quality review audits on malpractice claims with third party claims management vendor
• Work with Actuarial, Finance company management to set reserving standards
• Working with claims vendor, manage all aspects of litigation from discovery through trial in the defense of physicians in claims alleging malpractice,
• Develop and manage relationships with claims vendor and staff, Attorneys, Investigators and Field Adjusting companies across the multiple state markets of operation
• Review and recommend performance metrics and cost savings in company claim operation.
• Investigate and implement, as required, automated solutions for electronic claims records, claims financials, and analytical reporting tools with Finance
• Recruit claims professional/staff, when required, to build an in-house claims operation.
• Increased business unit performance by driving implementation of best claims practices.
Requirements:
• Keen understanding of efficiently adjudicating medical professional liability insurance claims in many states, as well as current health care market, tracking the changes in legislation and tort reforms.
• 10 years of experience in the insurance industry, with proven results specializing in medical professional liability insurance claims, loss prevention, and risk management.
• Bachelors degree required, licensed Health Care Risk Manager and Master Degree preferred. Law degree highly desired.
• Expertise in developing and enhancing Information Technology related to claims management systems.
• Keen relationship-building skills with ability to bring a high energy level to the management team.
• Strong belief and skills in customer service and diplomacy with ability to manage multiple staff at off-site third party vendor.
Published on Aug 11, 2010
Viewed: 387 times
Viewed: 387 times
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