Claims Representative - Legal Affairs & Risk Management

NewYork-Presbyterian Hospital: Claims Representatives - Make It Possible

At NewYork-Presbyterian Hospital, we commit world-class resources to patient care with amazing results. As the healthcare industry rapidly evolves, we depend on our exceptional litigation management team to help us maintain the interity of our care. We’re saving lives and leading the field of medicine, and now you can help make it possible.

We are currently seeking a dynamic and highly knowledgeable Claims Representative to join our team. In this position, you will be responsible for the overall management of healthcare-related professional liability and associated general liability claims. Your knowledge of claims policies and guidelines will be crucial as you review coverage, direct claims investigations, monitor and control activities of outside defense counsel, determine liability and compensability, secure information, and negotiate and settle claims with plaintiff counsel.

This position also will also:

• Review, evaluate and analyze information relating to claims, lawsuits and events by reviewing medical records, conducting interviews with hospital staff, and collecting evidence related to claims.  You’ll determine exposure and report findings to Associate General Counsel/Director of Claims and Litigation Management; and evaluate, set and maintains reserves within assigned authority levels.

• Facilitate effective communication with hospital administration, professional and ancillary staff and outside legal counsel in order to assist in the defense of cases, which includes the preparation of cases for trials.

• Administer the professional and general liability insurance program, review correspondence, meeting with, guiding, and directing outside defense counsel to ensure compliance with the hospitals claims management program.

• Engage in settlement negotiations with plaintiffs’ attorneys within assigned authority levels, direct further action regarding defense strategy, settlements or appeals. Manage approved investigation including use of surveillance, outside expert opinions and physical examinations.

This is a full time position working 4 days at our Corporate Office in mid-town Manhattan and the ability for 1 day remote.

Preferred Criteria

• Bachelors of Science in Nursing or other clinical degree with previous clinical experience
• Professional liability claims management experience

Required Criteria

• Bachelor’s degree
• Three to five years clinical experience or insurance industry claims management