Claims Adjuster ( Medical Liability Analyst ) (Hybrid) Job at KAMMCO, Wichita, KS

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  • KAMMCO
  • Wichita, KS

Job Description

POSITION SUMMARY Proactively manage medical professional liability and general liability claims (including investigation and evaluation of liability and damages), monitor claims defense litigation, advocate on behalf of insured healthcare providers in claims and litigation processes, communicate and collaborate with claims staff, assist and interact with member insureds and attorneys in the litigation process and maintain internal administrative documentation. The MLA is responsible for claim procedure functions as outlined in the claims department procedures and protocol manual utilizing a high degree of initiative and autonomy. DUTIES AND RESPONSIBILITIES Collaborate with co-workers, member insureds, attorneys, and the Kansas Healthcare Stabilization Fund. Make initial contact with insured, claimants and/or claimant attorneys when assigned claims, and continuously communicate with and support insured throughout claim and litigation process. Proactively manage the administration of assigned claims, including but not limited to: Obtaining all required information and making all necessary contacts to fully investigate claims; Arranging for evaluation of medical records; Preparing internal documentation and verbally presenting claim recommendations; Independently evaluating claim value and determining reserves for claims; Handling negotiations for potential settlement of claims; and Reviewing and approving all invoices from attorneys and other vendors. In litigated matters, collaborate with defense counsel in defending and evaluating cases. Attend all settlement conferences, relevant depositions, and trials on behalf of KAMMCO; attend and support insureds, spouse and defense attorney at trial. QUALIFICATIONS Insurance claim adjuster experience or relevant educational degree (paralegal, nursing/ healthcare, bachelor, certification, or J.D.) preferred. Strong medical and/or legal experience preferred. Excellent communication skills, including the ability to negotiate and mediate required. Strong analytical skills and ability to evaluate liability and damages issues in connection with liability claims. Must be able to proactively perform duties and tackle complex challenges within authority without supervision. Must be willing to travel extensively as requested; must have a valid driver’s license. Must be able to assertively communicate and perform in an adversarial setting. Must be able to work independently as well as in a team environment. Proficient at Microsoft Office Suite (including Word, Excel, and Outlook), and demonstrates ability to quickly learn other industry related software platforms. WORKING CONDITIONS Professional office environment. Contact with medical office staff, member insureds, attorneys and the general public. MLA may encounter conflict and interaction with member insureds, attorneys, and/or claimants who may be anxious, frustrated or upset. Multi-task position requiring ability to take initiative and strong attention to detail. Requires extensive travel in a vehicle. Employment Type: Full Time Salary: $65,000 - $70,000 Annual Bonus/Commission: No

Job Tags

Full time, Work at office

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