Direct Claims Jobs in Tennessee (NOW HIRING)

Director, Claims

Remote

Company Overview: AMSURG is an independent leader in ambulatory surgery center services, operating a network of more than 250 surgery centers nationwide. In partnership with physicians and health systems, the organization delivers high-quality care for patients across a diverse spectrum of medical specialties, including gastroenterology, ophthalmology and orthopedics. To learn more about AMSURG, visit www.amsurg.com.

POSITION SUMMARY:

Responsible for the investigation and handling of claims related to General Liability / Professional Liability, Employment Practices Liability, Cyber, and Property lines of coverage.  Understands and communicates, as well as educates, claims management philosophy and strategy to Corporate and Center staff while building, maintaining, and managing relationships with claims adjusters and outside legal counsel. Designs, analyzes and delivers claim information to influence risk management behavior through performance metrics and benchmarking.  Management of claims staff.

Work Schedule: Remote (Preferably Dallas, TX or Nashville, TN but candidates can reside anywhere in the United States).

ESSENTIAL RESPONSIBILITIES:

• Oversight of the reporting of all claims to the insurance carriers and initiates the investigation of all Employment Practices Liability, Cyber, Property, General Liability, and Professional Liability claims.  Assist in the investigation and reporting of Workers Compensation claims.
• Handle claims within the Corporate or Center deductibles/retentions.
• Responsible for the claims documentation in the RL6 Claims Management System as well as the in-house RMIS database, and produce reports from the systems.
• Advises and assists Corporate and Center Staff in conducting investigations of incidents, including interviewing of witnesses and procurement of relevant documentation.
• Establish relationships with defense attorneys and assist in discovery and investigation.
• Provides training on claims reporting to Corporate and Center staff and helps communicate Workers Compensation benefits and the importance of the Return-to-Work policy.
• Prepares reports and analyses for the VP of Insurance/Corporate Risk Management summarizing the loss data provided by insurance companies, highlighting adverse trends and their financial impact, and making recommendations on how to minimize/avoid the risks.
• Conducts claims meetings with insurance carriers on a quarterly basis to evaluate open reserves.
• Obtains and tracks centers’ historical claims data needed for the actuarial study.

QUALIFICATIONS: 

To perform this job successfully, an individual must be able to perform each essential responsibility satisfactorily.  The requirements listed below are representative of the knowledge, skills and/or abilities required.

Education/Experience:

• Bachelor degree from an accredit college or university with a minimum of six (6) years’ experience as a claims handler required. Professional Liability and Workers Compensation experience highly preferred.  

Mathematical Skills:

• Ability to add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions, decimals and percentages.

Technical Skills:

• Expert in Microsoft Excel and experience with financial reporting systems is required. Ability to work with web-based claims management system and prepare reports also required.

Language Skills:

•  Ability to understand, read, write and speak English.  Ability to read, analyze and interpret general business periodicals, professional journals, technical procedures or governmental regulations.  Ability to successfully write business correspondence.  Ability to effectively present information, respond to questions and professionally interact with managers, employees, clients, vendors and the general public.

Reasoning Ability:

• Ability to recognize and define problems, collect data, establish facts, draw valid conclusions and correct errors.  Ability to understand and interpret basic financial data.  Ability to interpret a variety of instructions in a variety of forms and deal with abstract and concrete variables.

 Other Qualifications:

•  Must be able to handle multiple, simultaneous tasks effectively and efficiently while maintaining a professional, courteous manner.  Must be able to work well with others.  Strong verbal and written communication skills required.  Must be detail oriented and organized.  High integrity, including maintenance of confidential information.  Must be able to exercise good judgment and positively influence and lead others, including handling confrontations with poise and efficiency.  Based on business need, the ability to work a flexible schedule, including some evenings and weekends as approved in advance.

Employment at AMSURG: Living Our Values Every Day
At AMSURG, our values define who we are and how we serve our patients, partners, and each other. As a national leader in ambulatory surgery, we are committed to a culture of excellence, integrity, teamwork and caring deeply. Our values guide every decision, ensuring we continue to elevate healthcare and provide the highest quality care.
These guiding principles are the foundation of our culture and a guide to how we collaborate, innovate, and make a difference every day.

• Care Deeply for those around us.
• Cultivate Integrity to build trust.
• Champion Excellence for continuous improvement
• Celebrate Teamwork every step to the way.

Benefits:

To ensure we retain and invest in great people, AMSURG provides its employees with the benefits, recognition, training, and opportunities needed for professional growth. Our wide range of health and welfare benefits allow you to choose the right coverage for you and your family. AMSURG offers a variety of health and welfare benefit options to help protect your health and promote your wellbeing. Benefits offered include but are not limited to: Paid Time Off, Medical, Dental, Vision, Life, Disability, Healthcare FSA, Dependent Care FSA, Limited Healthcare FSA, FSAs for Transportation and Parking & HSAs, and a matching 401(K) Plan.

Paid Time Off:

AMSURG offers paid time off, 9 observed holidays, and paid family leave. You accrue Paid Time Off (PTO) each pay period and depending on your position and can earn a minimum of 20 days and up to 25 days per calendar year.

EOE Statement:

AMSURG is an Equal Opportunity Employer (EOE). Qualified applicants are considered for employment without regard to age (40 or older), race, color, religion, gender, sex, national origin, pregnancy, sexual orientation, disability, genetic information or any other status protected under applicable federal, state, or local laws. We strive to also provide a disability inclusive application and interview process. If you are a candidate with a disability and require reasonable accommodation in order to submit an application, please contact us at: careers@amsurg.com. Please include your full name, the role you’re applying for and the accommodation necessary to assist you with the recruiting process. 

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