Job Description
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description To handle complex or high exposure claim issues; to provide medical knowledge of the health care system and health care issues; to independently investigate, analyze and evaluate medical malpractice claims for self-insured and commercially insured clients; to provide information needed to clients as needed to determine liability issues and exposure; and to assist in identification of risk management issues to decrease liability exposure and associated legal costs.
• Handles complex or high exposure claim issues; advises and leads Nurse Consultant - PL colleagues. • Receives requests for investigation; reviews and develops action plans and investigates cases accordingly. • Collects data from Company and clients to document and communicate results as appropriate. • Prepares reports summarizing medical records and interviews; outlines issues related to summary reports; and provides analysis and recommendations for further claims handling. • Interviews practitioners involved in medical malpractice claims at hospital facilities weekly as needed.
• Participates in follow-up review and investigation as directed and assists in discovery requests as needed. Qualifications • Bachelor's degree from an accredited college or university preferred. • RN license required. • LNC (Legal Nurse Consultant) Certification or training preferred. • Five (5) years related clinical nursing experience and two (2) years nurse consultant experience required. • General or
Professional Liability investigation related experience preferred. • Technical claims knowledge of medical malpractice claims procedures and practices and/or general liability.
• Excellent oral and written communication, including presentation skills. • PC literate, including bolthires Office products. • Analytical and interpretive skills. • Strong organizational skills. • Excellent interpersonal skills. • Ability to work in a team environment. • Ability to meet or exceed Performance Competencies. Benefits • Three Medical, and two dental plans to choose from. • Tuition reimbursement eligible. • 401K plan that matches 50% on every $ you put in up to the first 6% you save. • 4 weeks PTO your first full year.
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