DIRECTOR, CLAIMS

Director, Claims

Remote

Company Overview: AMSURG is an independent leader in ambulatory surgery center services, operating a network of more than 250 surgery centers nationwide. In partnership with physicians and health systems, the organization delivers high-quality care for patients across a diverse spectrum of medical specialties, including gastroenterology, ophthalmology and orthopedics. To learn more about AMSURG, visit www.amsurg.com.

POSITION SUMMARY:

Responsible for the investigation and handling of claims related to General Liability / Professional Liability, Employment Practices Liability, Cyber, and Property lines of coverage.  Understands and communicates, as well as educates, claims management philosophy and strategy to Corporate and Center staff while building, maintaining, and managing relationships with claims adjusters and outside legal counsel. Designs, analyzes and delivers claim information to influence risk management behavior through performance metrics and benchmarking.  Management of claims staff.

Work Schedule: Remote (Preferably Dallas, TX or Nashville, TN but candidates can reside anywhere in the United States).

ESSENTIAL RESPONSIBILITIES:

• Oversight of the reporting of all claims to the insurance carriers and initiates the investigation of all Employment Practices Liability, Cyber, Property, General Liability, and Professional Liability claims.  Assist in the investigation and reporting of Workers Compensation claims.
• Handle claims within the Corporate or Center deductibles/retentions.
• Responsible for the claims documentation in the RL6 Claims Management System as well as the in-house RMIS database, and produce reports from the systems.
• Advises and assists Corporate and Center Staff in conducting investigations of incidents, including interviewing of witnesses and procurement of relevant documentation.
• Establish relationships with defense attorneys and assist in discovery and investigation.
• Provides training on claims reporting to Corporate and Center staff and helps communicate Workers Compensation benefits and the importance of the Return-to-Work policy.
• Prepares reports and analyses for the VP of Insurance/Corporate Risk Management summarizing the loss data provided by insurance companies, highlighting adverse trends and their financial impact, and making recommendations on how to minimize/avoid the risks.
• Conducts claims meetings with insurance carriers on a quarterly basis to evaluate open reserves.
• Obtains and tracks centers’ historical claims data needed for the actuarial study.

QUALIFICATIONS: 

To perform this job successfully, an individual must be able to perform each essential responsibility satisfactorily.  The requirements listed below are representative of the knowledge, skills and/or abilities required.

Education/Experience:

• Bachelor degree from an accredit college or university with a minimum of six (6) years’ experience as a claims handler required. Professional Liability and Workers Compensation experience highly preferred.  

Mathematical Skills:

• Ability to add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions, decimals and percentages.

Technical Skills:

• Expert in Microsoft Excel and experience with financial reporting systems is required. Ability to work with web-based claims management system and prepare reports also required.

Language Skills:

•  Ability to understand, read, write and speak English.  Ability to read, analyze and interpret general business periodicals, professional journals, technical procedures or governmental regulations.  Ability to successfully write business correspondence.  Ability to effectively present information, respond to questions and professionally interact with managers, employees, clients, vendors and the general public.

Reasoning Ability:

• Ability to recognize and define problems, collect data, establish facts, draw valid conclusions and correct errors.  Ability to understand and interpret basic financial data.  Ability to interpret a variety of instructions in a variety of forms and deal with abstract and concrete variables.

 Other Qualifications:

•  Must be able to handle multiple, simultaneous tasks effectively and efficiently while maintaining a professional, courteous manner.  Must be able to work well with others.  Strong verbal and written communication skills required.  Must be detail oriented and organized