HCA, Hospital Corporation of America Senior Claims Supervisor in Nashville, Tennessee
HCA, a Fortune 100 company with more than 200,000 employees, is one of the nation's leading providers of healthcare services, operating over 170 locally managed hospitals and over 100 freestanding surgery centers in 20 states and the United Kingdom. With its founding in 1968, HCA created a new model for hospital care in the United States, using combined resources to strengthen hospitals, deliver patient-focused care and improve the practice of medicine. HCA is a learning healthcare system that uses more than 27 million annual patient encounters to advance science, improve patient care and save lives. HCA has been named one of the world's most ethical companies for eight years in a row. At HCA, we are driven by a single goal: the care and improvement of human life.
JOB DESCRIPTION * This position is one of the professional staff positions in the HCI Claims Department and in the larger Risk & Insurance Department reporting to a Director of Claims. The Senior Claims Supervisor is responsible for directly managing approximately 150-200of the Company’s professional and general liability claims. This includes retaining and supervising external and internal claims investigators, defense counsel and regularly interacting with various facility representatives and leaders. Ideally, this individual has experience managing physician practice and hospital claims and litigation management, is familiar with physician practice and hospital operations (including medical staff issues),state malpractice laws, possesses strong negotiation skills and has demonstrated ability to proactively manage and resolve claims. *Caseload may change based on overall volume of department.
GENERAL RESPONSIBILITIES * Directly manage between150-200 of the Company’s liability claims to achieve fair, efficient and timely resolution of all matters. * Retain and supervise directly defense counsel and claim investigators. * Lead the defense team in coordinating case strategy with all stakeholders, including external or internal investigators, defense counsel, hospital Risk Management and other Corporate Departments. * Assign indemnity and expense reserves supported by the ongoing analysis of cases and appropriately document the rationale for decision. Upon successful completion of training and orientation, the individual will have authority to establish reserves up to $250,000. * Maintain claim caseload on a regular review schedule and diary. * Effectively participate in settlement negotiations, mediations and trials as required for optimal outcomes. Upon successful completion of training and orientation, the individual will have authority to settle claims up to $250,000. * Identify and analyze claims and prepare summaries and reports as needed for presentation to Director of Claims (also for AVP, VP, Claims Committee and excess and reinsurers as needed). * Maintain accuracy of claims data in electronic claims system. * Approve claims expenses and litigation fees as appropriate. * Build and maintain strategic alliances and collaborative partnerships with the HCI Risk Management team, HCA Law Department, Clinical and Physician’s Services Group and other corporate departments that will mutually benefit the Claims Department and the organization. * Actively participate in committees or task forces as assigned that call for claims input and experience. * Develop and maintain effective, efficient and respectful working relationships with various facility representatives and leaders. * Maintain current knowledge of laws and rules affecting liability claims in assigned jurisdictions. * Perform other duties as assigned.
Minimum of 5 years of claims and litigation management experience, preferably in healthcare and preferably in a multi-state environment. Knowledge of physician practice, hospital or healthcare operations (including medical staff issues) is a plus. Experience in general liability and/or workers’ compensation claims may substitute for healthcare related experience.
College Graduate Preferred Certification in risk management or insurance is a plus, e.g. CPHRM, ARM, CPCU, etc. Adjuster’s license in states in which HCI operates, especially Florida, is a plus.
Must be eligible to apply for and obtain adjusters license(s) in assigned jurisdictions. Proficient computer skills with word processing and database competency. Effective oral and written communication skills. Critical thinking and analytical skills. Effective time management skills.
Title: Senior Claims Supervisor
Location: Tennessee-Nashville-1100 Charlotte - Capitol View
Requisition ID: 10201-22032