Senior Claims Professional And Risk Advisor Ppm

Profile

Senior Claims Professional and Risk Advisor PPM

The candidate investigates and evaluates liability, causation and damages in direct patient and litigated claims. Ensures proper file documentation of assigned files, by complying with company and state requirements. Establishes and continually evaluates case reserves. Accountable for the full handling and control of all claim files assigned from inception to resolution including timely communication; investigation; and reserve adequacy; diary maintenance; management of defense and coverage counsel; reinsurance reporting; and claim disposition. Responsible for preparing reports for management, by collecting, analyzing, and summarizing claim information. Consistent, prompt evaluation of potential exposure to all claims assigned as well as an ability to adapt to changing circumstances as claims develop. Ability to consider and formulate a possible resolution strategy at the earliest possible opportunity, including setting appropriate and timely reserves and communicating with defense counsel, insureds or others to successfully achieve such strategy. Claim presentations, both written and oral, will be required on a regular and timely basis to bring management up to speed, obtain authority and/or formulate appropriate action plans. Collaborates with defense counsel with regard to defense tactics and strategies, per department guidelines. Maintains communication with Counsel. Participates in the selection of expert witnesses. Superior customer service to all co-employees, agents, policyholders and others encountered during the claims-handling process is expected. Attends trials, settlement conferences, mediations, and insured meetings. Reviews and approves reasonable legal expenses and fees associated with the claim file, and negotiation of adjustment of charges when appropriate. Participates in settlement negotiations. Conducts risk management presentations for insureds based on established program content that covers latest healthcare professional liability concerns. Fields and researches inquiries from insureds and other departments related to healthcare professional liability risks and escalates matters to the Lead Claims Professional and Risk Advisor or Claims management. Performs special projects as assigned.

Additional Information

Requisition id: R2516.

Company info

ProAssurance
100 Brookwood Place Suite 500
Birmingham
Alabama
United States 35209
Website : http://www.proassurance.com