Sr. Professional Liability Medical Claims Manager

Sr. Professional Liability Medical Claims Manager

Providence is calling a Sr. Professional Liability Medical Claims Manager to investigate, evaluate, and manage professional, general, and other liability claims under the PSJH Insurance Program. This position supports claims handling across multiple states where eligible.

Responsibilities

• Communicate with patients, claimants, caregivers, providers, and leadership
• Review and analyze medical records, interview witnesses, assist with the discovery process, and communicate with facility risk management regarding evaluation and investigation
• Write insurance policy coverage letters and analyze policy documents to address coverage
• Set appropriate indemnity and expense reserves
• Select appropriate medical experts for case review
• Develop a plan of action for assigned claims and update the claims file as statuses change
• Review and approve statements for services and take steps to pay vendors
• Inform Senior Manager Operations of large or complex claims and claims with potential media exposure
• Report claims with potential excess exposure to excess insurers
• Ensure compliance with claims reporting procedures and required regulations
• Work with defense attorneys specializing in defense of medical negligence claims
• Foster teamwork, operational excellence, and effective communication within the claims team
• Develop and document for each claim a plan of action for resolution by settlement, trial, or other means
• Maintain electronic files with all material communications, analyses, expert opinions, interview summaries, and related documents in accordance with policy

Qualifications

Required

Preferred

Salary Range and Location

Why Join Providence?

Providence offers best-in-class benefits designed to support you and your family in staying well, growing professionally, and achieving financial security. We emphasize patient-focused care, inclusion, and mutual respect across our 120,000 caregivers across multiple states.

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