POSITION OBJECTIVE: The Medical Malpractice Claim Attorney/Examiner directs and supervises the litigation, investigation and disposition of claims and lawsuits and coordinates development to insured client hospitals, physicians and carrier representatives.
Assigns counsel to defend lawsuits. Works with counsel to develop the litigation strategy. Reviews, analyzes and documents defense counsel correspondence and expert reviews. Coordinates investigation of claims and lawsuits. Monitors trial/case developments and communicates with carriers and hospital representatives. Responds to carrier inquires.
Conducts regularly scheduled claim conferences with carrier, hospital representatives and defense counsel to develop defense/settlement strategies and obtain settlement authority.
Provides written and oral communication to insureds regarding commencement, settlement and/or disposition of lawsuits.
Evaluates and coordinates resolution of insurance coverage issues and overlapping insurance coverage situations.
Analyzes and quantifies damages. Establishes reserves for future claim management.
Negotiates settlements with claimants or attorneys.
Directs assignment of medical expert witnesses.
Evaluates sufficiency of settlement documents and directs settlement payments.
Oversees routine claims administration (openings, closings, NPDB reporting) and approves provider bills/expenses.
Accurately documents all actions in Oasis claim system.
Performs other duties or special projects as required or as assigned.
Correctly and accurately evaluates liability and damages and sets appropriate reserves for 100% of assigned claims. Ensures reserve increase notes appropriately address liability and damage issues for 100% of assigned cases.
Maintains accurate Oasis claims data and meaningful diaries for 100% of assigned claims.
Monitors defense counsel activities and approves or disapproves pending budgets within 7 business days.
QUALIFICATIONS AND REQUIREMENTS:
Excellent interpersonal and organizational skills.
Good knowledge of medical malpractice law.
Good listening skills.
Good negotiating skills.
Good Microsoft Office Suite skills.
Healthcare Risk Advisors