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    Claims Examiner

    Kaiser Permanente
    Rockville, MD 20852
    Full-time
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    Job Description

    Description:

    Responsible for the administration of medical malpractice and other professional and general liabilty claims made during the course of conducting company business across the enterprise, having a material impact on legal reserves that are listed as a separate line item on the company's financial statements. The collective value of claims settled, as influenced by this job function, have direct implications for KP's bottom line. The resolution of these claims can also have ramifications for KP's reputation as well as potential regulatory involvement. Ensure claims are handled appropriately within the National Claims Guidelines and successfully resolved, including retention of outside defense counsel, in-house resolution, monitoring of legal fees, costs and settlement expenses, attendance at court proceedings, provision of claims analysis in leadership committees and identification of insurance coverage applicability.

    Essential Responsibilities:
  • Provide support on medical malpractice claims and premises liability claims brought against Kaiser Permanente. Together with the responsible attorney in the public and professional liability practice group, manages the disposition of professional liability and general liability claims.
  • Claims Management: Ensures compliance with internal PPL policies for management, handling & reporting of small claims.
  • Investigates pre-suit claims and disposition of potentially compensable events, including representation of KP interests in the settlement of small court claims and/or participation in small court claims proceedings.
  • Updates and maintains claims database; inputs into national claims-related databases.
  • In support of larger claims, serves as lead on retrieval of arbitration documents for motions to compel arbitration.
  • Meets with claimants to negotiate settlements. Attends meetings with physicians and managers as needed.
  • Prepares reports of all claims to DHS on a quarterly basis of closed cases.
  • In support of larger claims, handles special projects for Lead Claims Counsel.
  • Fiscal Management: Oversees and manages SOX and Financial Audits with auditors. Establishes and conducts quarterly review of reserve information.
  • Basic Qualifications:

    Experience
  • Minimum two (2) years of related experience with a commercial professional liability insurer required. The commercial professional liability insurer experience may be substituted for related experience with a self-insured trust, captive insurer, or physician indemnification program, handled either by an internal corporate legal dept, or outside law firm, or equivalent experience
  • Education
  • Bachelor's degree in a related field, OR four (4) years directly related experience.
  • High School Diploma or General Education Development (GED) required.
  • License, Certification, Registration
  • N/A
  • Additional Requirements:
  • Investigative experience in corporate risk exposure.
  • Strong computer skills with proficiency in Microsoft Office.
  • Must be able to work in a Labor/Management Partnership environment.
  • Preferred Qualifications:
  • N/A
  • Primary Location: Maryland,Rockville,Rockville Regional Offices Additional Locations: United States Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri Working Hours Start: 8:00 AM Working Hours End: 5:00 PM Job Schedule: Full-time Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: NUE-PO-01 NUE Non Union Employee Job Level: Entry Level Job Category: Legal / Government Relations Department: National Legal Department Travel: Yes, 5 % of the Time Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.

    External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.

    Posting ID: 582806854Posted: 2020-12-23