Description
Introduction
Do you want to join an organization that invests in you as a East Florida Division Claims Administrator? At HCA Healthcare, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years. This position will be based in East Florida - Ft. Lauderdale, Miami, or Palm Beach. Candidate must reside in this area or be willing to relocate to this area.
Benefits
HCA Healthcare offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:
Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
Free counseling services and resources for emotional, physical and financial wellbeing
401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
Employee Stock Purchase Plan with 10% off HCA Healthcare stock
Family support through fertility and family building benefits with Progyny and adoption assistance.
Referral services for child, elder and pet care, home and auto repair, event planning and more
Consumer discounts through Abenity and Consumer Discounts
Retirement readiness, rollover assistance services and preferred banking partnerships
Education assistance (tuition, student loan, certification support, dependent scholarships)
Colleague recognition program
Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.
Learn more about Employee Benefits (https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards)
Note: Eligibility for benefits may vary by location.
You contribute to our success. Every role has an impact on our patients' lives and you have the opportunity to make a difference. We are looking for a dedicated East Florida Division Claims Administrator like you to be a part of our team.
Job Summary and Qualifications
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. As the Division Claims Administrator, you will have broad responsibility for the local coordination of information and document gathering in the course of investigating and defending professional and general liability claims within an assigned territory. This includes supervision of centralized claims staff and is responsible for their facilitation of claims investigation, legal discovery, depositions, mediation, settlement and trials through coordination with Defense Counsel, Investigators, HCI, Facility Patient Safety/Risk Managers, Hospital Administration, Division Leaders, physicians, and patients/families. You will be responsible for directly managing a caseload of the Company's professional liability claims, including in-depth analysis, setting reserves, deciding if a claim should be settled or defended and ultimately bringing that claim to a resolution. You will be responsible for retaining and supervising outside Defense Counsel and regularly interacting with various facility representatives and leaders. You will also assist in identification of claim trends and reinforcement of risk mitigation efforts with clinical leaders throughout their assigned territory.
Job Responsibilities:
Engage in the department and company strategy and philosophy of proactive, efficient and effective claims management.
Manage local claims workflow/processes from the time a probable claim is filed through closure. Assure timely collection and accurate recording of all claims related documents; coordinate with HCI Defense Counsel and/or Investigators for release of records and information in response to subpoenas, court orders, attorney requests, and inquiries from other outside sources. Timely production of such requested information is necessary to remove the administrative burden from the hospital patient safety directors, allowing them to focus on clinical risk mitigation efforts.
Assist HCI's claim evaluation process by representing and communicating the local facility's interests; and, when appropriate, obtain settlement authority from HCI claims personnel to settle or resolve claims.
Handle professional liability cases with a designated caseload. This includes strategic thinking towards resolution, as well as collaborating, directing and managing outside Defense Counsel as warranted.
Continuous and appropriate documentation within, and maintenance of, the electronic claims system for designated caseload, including reviewing daily diaries of files to track progress and items needed for updates.
Serve as the facility representative in mediations and trials whenever requested.
Supervise the Division Claims Coordinator; conduct orientation and training, assign his/her work duties, and evaluate performance.
Coordinate with the PSO and senior leadership regarding potential claims issues that could significantly affect the hospital or staff.
Routinely visit assigned hospitals, meeting with patient quality staff to help them better focus on risk mitigation efforts where trends, or meaningful exposures may be developing.
Attend hospital and Division meetings as available.
Maintain performance against department established metrics.
Develop and maintain positive customer relationships.
Comply with all relevant state codes, laws, rules and regulations related to the claim coordination responsibilities.
Job Requirements Include:
Bachelor's Degree is required
Master's Degree (MBA, MPH, MHA, MSH, or JD) is preferred
5+ years of experience in claims management, hospital operations, or risk management role is required
1+ year(s) of experience in hospital acute care nursing role is preferred
Florida Adjuster's License (or eligibility to obtain license is required) is preferred
Licensed Healthcare Risk Manager (LHRM) is preferred
Certification in Healthcare Risk Management (CPHRM) is preferred
This job may require up to 50% travel
HCA Healthcare (Corporate), based in Nashville, Tennessee, supports a variety of corporate roles from business operations to administrative positions. Like our colleagues in any HCA Healthcare hospital, our corporate campus employees enjoy unparalleled resources and opportunities to reach their potential as healthcare leaders and innovators. From market rate compensation to continuing education and career advancement opportunities, every person has a solid foundation for success. Nashville is also home to our Executive Development Program, where exceptional employees are groomed to take on CNO- and COO-level roles in our hospitals. This selective program focuses on ethics, leadership and the financial and clinical knowledge required of professionals at this level of the industry.
HCA Healthcare has been recognized as one of the World's Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.
"Good people beget good people."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder
We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Division Claims Administrator opening. Qualified candidates will be contacted for interviews. Submit your resume today to join our community of caring!
We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
