Medical Professional Liability Claims Analyst - Pediatrix

Overview:

 

We have an exciting Medical Professional Claims Analyst career opportunity for an experienced professional to join our team at Pediatrix Medical Group. We are a physician led organization, and one of the nation’s largest providers of prenatal, neonatal and pediatric services.

 

Talented business professionals from diverse backgrounds choose Pediatrix because we are an exciting and innovative company that focuses on a team approach to improve the lives of patients everywhere.  We offer a diverse range of opportunities, competitive salaries and benefits, and a commitment to clinical excellence, we are confident that you'll love being a part of the Pediatrix team. 

Responsibilities:

The Medical Professional Claims Analyst provides support as a member of the Company’s Medical Professional Claims and Liability Program.The ideal candidate will serve an integral role in the administration of Professional Liability claims and litigation management, while delivering exceptional internal and external customer service in alignment with company and department goals. 

 

• Monitor potential legal matters received by the Company through its Registered Agent, affiliate practices, and/or employees, and timely respond to specific requests or claims based upon internal guidelines

• Maintain the Medical Professional Claims and Liability Program’s Intake Control Log by evaluating and appropriately  categorizing documents received during the claims process in the claims management system.
• Refer Non-Medical Malpractice related matters to appropriate departments including, but not limited to, Regulatory, Compliance, Patient Accounts, Corporate Legal Department, and People Services.
• Initiate and complete all aspects of the claims process, including but not limited to documenting the claims management system, filing claims with appropriate insurance carriers, confirming attorney assignments, and documenting the Intake Log in accordance with the Program’s guidelines.
• Scheduling meeting, mediations, trials, etc

• Assist in the management of Loss Runs, including entering and managing data.Review insurance and employment/service agreements to determine appropriateness of coverage.
• Provide the highest-level customer service when contacting health care providers or involved parties in alignment with the expectations of the Company.
• Review Audit Intake Log on a monthly basis to verify accuracy and report discrepancies to the respective Claims Manager or other appropriate person.
• Audit and analyze claims files on a monthly basis for compliance with internal and external guidelines 
• Provide reports to  the respective Claims Manager for use with quarterly disclosure letters to company’s external auditors
• Perform other duties as assigned

Qualifications:

Education:

• Bachelor's degree (B.A.) from a four-year college or university; or one-to-two years legal /claims related experience and/or training; or equivalent combination of education and experience.

Experience:

• Experience as a Medical Malpractice Claims Adjuster or Claims Analyst preferred.
  Paralegal or Legal Assistant with Medical Malpractice litigation experience preferred, but not required.
• Healthcare experience preferred, but not required.
• Experience in the administration of corporate claims management processes is a plus. 

   Skills:

• Strong written and verbal communication skills required
• Proficiency with computer software systems required.
• Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. 
• Ability to write reports, business correspondence, and procedure manuals. 
• Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.
• Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. 
• Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.

Benefits and Compensation:

Benefits for Full Time employees and qualified dependents: 

• Medical, Dental, Vision Insurance
• Progyny Fertility Benefits
• Teladoc Health and Second Opinion Services
• 401(K) Thrift Program & Sharing Plan**
• Employee Stock Purchase Plan (ESPP) – 15% discount*
• Basic Employee; Spouse; Child Life Insurance
• Accidental Death and Dismemberment (AD&D)
• Employee Optional Life and AD&D
• Short & Long Term Disability
• Pre-Tax Health Savings Accounts (HSA)
• Employee and Dependent Flexible Spending Account (FSA)
• Family Medical Leave Act (FMLA)
• Parental Leave Benefit
• Sick Pay Bank
• Employee Assistance Program (EAP)
• Group Aflac Policies
• Identity Theft Protection
• Employee Charitable Fund
• Care.com
• Continuing Education Assistance
• Various Discount Programs

*Part Time Regular employee classifications also receive this benefit

**Available to part-time regular and part-time casual employees aged 21 and over

About Us:

 

Pediatrix Medical Group is one of the nation’s leading providers of highly specialized health care for women, babies and children. Since 1979, Pediatrix has grown from a single neonatology practice to a national, multispecialty medical group. Pediatrix-affiliated clinicians are committed to providing coordinated, compassionate and clinically excellent services to women, babies and children across the continuum of care, both in hospital settings and office-based practices. The group’s high-quality, evidence-based care is bolstered by significant investments in research, education, quality-improvement and safety initiatives. 

 

Please Note: Fraudulent job postings/job scams are becoming increasingly common. All genuine Pediatrix job postings can be found through the Pediatrix Careers site: www.pediatrix.com/careers.

#PedNC

Pediatrix is an Equal Opportunity Employer:

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.