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Mercy Health BSMH

Senior Claims Manager

Posted an hour ago
5-10 years experience
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AI Summary

The Senior Claims Manager oversees complex medical malpractice claims and manages defense counsel effectiveness. They also provide leadership to staff while representing the organization in legal proceedings such as mediations and trials.

Summary of Primary Function/General Purpose of Position

Effectively and efficiently manages complex and large exposure medical malpractice claims, including hospital and employed physician claims and claims covered by the deductible polices.  Acts as the BSMH representative at pre-trial hearing, mediations, arbitrations and attends most trials. Manages and directs staff in accordance with organizational objectives and goals.

This is a remote/work from home position. Hire must be able to work eastern time zone hours.


Essential Job Functions

  • Manages the analysis of defense counsel effectiveness on an annual basis

  • Implements and tracks claims related to the Early Liability Review Program

  • Timely setting of accurate reserves based on formula (where possible)

  • Identification of potential claims at the time of reporting and appropriate follow up such as expert evaluation prior to suit or notice of potential suit

  • Works extensively with outside defense counsel to manage the claims

  • Verifies accurate billing of outside defense counsel

  • Manages policy reviews to assure appropriate scope of coverage within commercial policies and assure congruence of coverage between commercial policies and the Captive.

  • While working with market and group senior leaders explain the risks and alternatives regarding various claim options.

  • Works closely with employed physicians when the physicians are named in a lawsuit

  • Works closely with the Risk management related to claim management

  • Manages closely with the insurance staff regarding coverage issues

  • Manages staff to meet organizational objectives. Provides direction and oversight of assigned duties and projects.

  • This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job related duties as required by their supervisor, subject to reasonable accommodation.

Employment Qualifications

  • Required Minimum Education: Bachelors

  • Preferred Education: Insurance Courses CPCU/AIC/ARM/INS Institute

  • Minimum Qualifications: 7 years handling Professional Liability Claims

As a Mercy Health associate, you're part of a Mission that matters. We support your well-being—personally and professionally. Our benefits are built to grow with you and meet your unique needs, every step of the way.

What we offer

  • Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible)
  • Medical, dental, vision, prescription coverage, HSA/FSA options, life insurance, mental health resources and discounts
  • Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders
  • Tuition assistance, professional development and continuing education support

Benefits may vary based on the market and employment status.

All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Mercy Health – Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employers, please email recruitment@mercy.com. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com

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