What are the responsibilities and job description for the Complex Claims & Litigation Adjuster, Center City (Full Time) position at Jefferson Health?
Responsibilities
Job Summary
Working under the general supervision of the Director of Claims and Insurance, responsible for handling all aspect of the highest exposure and miscellaneous professional liability claims, including class actions and high exposure matters, from inception through conclusion brought against Jefferson.
Essential Functions
Minimum Education and Experience Requirements:
Education:
Experience:
Covid Vaccination is a requirement for employment at Jefferson for employees working at Jefferson’s clinical entities or at the University. If you are not currently vaccinated you will be required to receive the vaccination prior to hire date if you are offered employment, unless you request and receive an approved medical or religious exemption from Jefferson.
Par Reference Code
105678
Job Summary
Working under the general supervision of the Director of Claims and Insurance, responsible for handling all aspect of the highest exposure and miscellaneous professional liability claims, including class actions and high exposure matters, from inception through conclusion brought against Jefferson.
Essential Functions
- Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.
- Analyze, determine, and communicate the appropriate coverage position. Effectively manage litigation by evaluating liability and damages and determining the appropriate course of action for case resolution through well-developed action plans.
- Negotiates claims settlements up to designated authority level.
- Coordinates legal defense by assigning attorneys, coordinating support for the investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines.
- Handle claims consistent with Mountain Laurel Risk Retention Group (MLRRG,) and corporate policies, procedures, and standard methodologies following statutory, regulatory, and ethics requirements.
- Uses appropriate cost containment techniques, including strategic vendor partnerships to reduce overall claim costs for the organization.
- Calculates and assigns timely and appropriate financial reserves to claims, monitors reserve adequacy throughout claim life.
- Maintain accurate documentation in the claim file and adhere to claim documentation standards.
- Prepare reports to senior leadership which address liability exposure, coverage issues, litigation strategies, and loss development.
- Refers cases as appropriate to supervisor and management.
- Represents Company in depositions, mediations, and trial monitoring as needed.
- Interact with other internal departments and external organizations, including underwriting, actuarial, finance, and operations as needed
- Other duties as assigned.
Minimum Education and Experience Requirements:
Education:
- Bachelor’s degree
Experience:
- A minimum of 5 years of complex professional liability claims management experience required. 10 years preferred.
- AIC encouraged
- Possess a strong knowledge of the legal system, litigation, claims trends, and industry practices.
- Superior negotiation skills within a litigation and non-litigation context.
- Proficiency with claims information management systems (CIMS), Excel, Word, and demonstrated aptitude with Windows-based operating systems.
- Strong presentation, interviewing, investigation, and negotiation skills.
- Ability to budget own time effectively. Refers cases as appropriate to supervisor and management.
- Ability to work in a team environment.
- Occasional work travel.
Covid Vaccination is a requirement for employment at Jefferson for employees working at Jefferson’s clinical entities or at the University. If you are not currently vaccinated you will be required to receive the vaccination prior to hire date if you are offered employment, unless you request and receive an approved medical or religious exemption from Jefferson.
Par Reference Code
105678
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