Under general supervision of the Director of Claim, the Claim Manager investigates and resolves professional and general liability incidents, claims and lawsuits involving Steward’s insureds to determine liability and exposure. Develops and maintains appropriate and professional business relationships with attorneys, Steward Risk Managers, administrators, physicians and employees.
• Conducts investigations of potential claims, claims and lawsuits involving Steward hospital clinical staff and employees.
• Prepares reports consistent with internal Policies and Procedures.
• Works closely with hospital Risk Managers and staff in providing claims advice to avoid potential exposure to the organization.
• Attends depositions of plaintiffs and defendants in pending litigation against TRACO insureds.
• Works with defense counsel in retention of appropriate experts for TRACO defendants. Attends meetings to evaluate opinion and presentation of potential experts.
• Makes recommendations as to disposition of matter, i.e. settlement or defense.
• Maintains contact with attorneys, vendors, claimants and defendants to insure; cost-effective handling of claims. Conducts initial review of expense and legal bills to ensure compliance with litigation management and billing guidelines.
• Complies with established departmental policies, procedures and objectives.
• Ensures compliance with Medicare, Medicaid and SCHIP Extension Act and/or satisfaction of any outstanding liens on claim files.
• Works on projects as directed