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Risk Management Claims Analysis Specialist - Finance

CHRISTUS Irving Corporate Office
Irving, TX
Full-time

Job Description

Summary :

This position monitors and controls the workflow of legal claims, maintains legal files and acts as a liaison between internal departments, CHRISTUS Legal Department and appointed counsel to gather discovery documents, arrange appointments, and telephone conferences.

This position also involves multiple Risk Management activities related to patient and visitor event investigations, subpoenas, generating reports, insurance, product recalls and the maintenance of evidence.

This position also involves inputting and maintaining root cause analysis documentation and following up to assure actions plans are completed.

Responsibilities :

  • Prepares claims files upon receipt of claim, petition or unasserted Potential Liability Event (UPLE)
  • Reviews claim letter or petition to determine necessary data
  • Gathers necessary medical records
  • Completes claims information summary sheet, composes appropriate notification email to CHRISTUS Health Risk Management, and completes all necessary forms for file documentation
  • Requests and distributes as appropriate, all pertinent documents to the hospital attorneys and CHRISTUS Health
  • Closes and purges closed files as indicated and prepares for storage
  • Maintains tracking system for all claims / lawsuits received as well as trial dates and settlements
  • Calendars trial dates and mediation dates to Manager’s calendar
  • Coordinates scheduling of individuals for investigation, pre-deposition and deposition conferences with CHRISTUS Health representative, and legal counsel
  • Coordinates and assists counsel with responses to discovery, interrogatories and requests for production
  • Assists claims investigation by scheduling and accompanying attorneys on incident site locations
  • Gathers evidence and / or documentation in response to claims reviewer or attorneys’ request
  • Communicating with aggrieved persons and witnesses to gather information
  • Gathers information from various departments related to analysis of visitor and patient events and inputs data into PROACT software for Human Factors Analysis Classifications investigations
  • Follows up with involved associates on action plans to assure completion
  • Maintains confidentiality of all information
  • Adapts easily to changes in assignments and environment

Requirements :

  • High School Diploma
  • 18 days ago
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