Methodist Health System

CLAIMS INVESTIGATOR (45130585)
Location: Dallas, Texas - United States
Posted: 2/23/2018

CLAIMS INVESTIGATOR

Full-time 8:30-5 Day RN Required

Your Job Purpose:
The Claims Investigator works under the direction of MHS attorneys and risk management leadership within the MHS Legal Affairs Department. This position researches law, investigates facts and records, and prepares documents to assist the MHS Legal Affairs Office in various litigation and claim matters with unique expertise in hospital and physician professional liability matters. Independently researches and analyzes law sources such as statutes, recorded judicial decisions, district and federal court records, legal and scientific medical articles, etc. to prepare various internal legal documents. Reviews various bills to ensure compliance with litigation guidelines, etc.
Your Job Requirements:
Nursing Degree from accredited college or university required
Clinical Nursing background required
Nursing Paralegal certification preferred but not required
1-2 years of nurse paralegal experience working in a litigation practice or in healthcare environment preferred
Knowledge of legal terminology and principles preferred but not required, knowledge of medical terminology required
Proficient in Microsoft Office (including Word, Excel, PowerPoint, Outlook), Document and/or Claims Management database systems, expense/billing and contract management systems. Hospital or healthcare industry knowledge/experience is preferred.
Superior oral and written communication skills
Strong process and confidentiality orientation
Detail oriented, logical, and methodological approach to problem solving
Demonstrated capability to interface and maintain effective relationships with all departments, employees, and outside defense counsel in a team-oriented environment
Your Job Responsibilities:
Investigates facts and independently prepares documents to assist internal and external attorneys and legal office team members with claim matters, written legal discovery responses, subpoena duces tecum preparedness, etc.
Reviews medical records to evaluate care, identifies potential witnesses, and prepares a case summary on cases identified as potential claims and takes a proactive role in raising questions about reserves based upon knowledge of discovery answers and facts of case as it develops.
Organizes and indexes complex case files using primarily electronic claim filing system
Performs wide variety of legal research, data compilation, and statistical reports with little or no supervision
Prepares reports, correspondence, chronologies, case summaries of medical malpractice, general liability, and other cases for internal decision making and claims management.
Communicates with witnesses, experts, and external defense counsel in preparation for depositions, mediations, arbitrations, and trials with attendance on behalf of MHS at such when applicable.
Oversees or reviews billing and expense data from external law firms in a timely manner, communicates items that don't adhere to MHS Litigation guidelines, and enters billing info into MHS claims management system for all claims.
Determines and calendars deadlines to help manage claims, insurance carrier notifications, and facilitate claim closures.
Attends the Risk Management and Closed Claim Committee meetings and provides routine summaries of claims outcomes or issues relevant to clinical risk and quality management.
Maintains confidential quality reviews, evidence, documents, and communication on legal cases. Ensures maximum protection from discovery of all such materials.
Completes other duties as assigned by the MHS Chief Legal Officer, Associate General Counsel, or Assistant VP, Corporate Risk Management at MHS.

Additional Requirments / Information

Job Capacity:Employee (full-time)
Minimum Education Level:See Job Description
Visa Sponsorship: No
Related Industries:Administration, Hospital

Methodist: Where life shines bright.


For more than 80 years, Methodist Health System has served families and communities in North Texas with compassionate, award-winning, leading-edge health care.


  • Surgeons on our medical staff have made history.

  • Our hospitals have won acclaim.

  • Our researchers have earned national recognition.

  • Our employees have voted Methodist Top 10 Best Places to Work in the Dallas-Fort Worth area - 6 years in a row.


But in all these decades, our mission has never changed - commitment to you, your family, and our community.


Please click below to learn more about our facilities:

*Methodist Health System has requested along with applying online at CampusCareerCenter.com you also fill out additional information on their site. Please click 'Apply Online' to begin the application process.

* If you would like to find out more about this position or this particular hospital, please click on the 'Information' button. We realize that you may need further information even if you are not ready to apply for a job at this time.

Who's Hiring

NSA Jobs Intel Jobs

Sponsors

Find Entry Level Jobs In:

Phoenix • Tucson • Palm Springs • Sacramento • San Diego • San Francisco • San Jose • Denver • Jacksonville • Miami • Orlando • Tampa • Atlanta • Chicago • Indianapolis • Kansas City • Louisville • New Orleans • Boston • Baltimore • Detroit • Grand Rapids • Minneapolis • Charlotte • Raleigh • Omaha • Atlantic City • Las Vegas • Reno • Buffalo • New York City • Cincinnati • Cleveland • Toledo • Tulsa • Portland • Philadelphia • Pittsburgh • Myrtle Beach • Memphis • Nashville • Austin • Dallas • Houston • San Antonio • Salt Lake City • Richmond • Seattle • Spokane

Partners:

CampusGovCampusRNCampusAlliedHealthCampusRXBioCampusEcoJustJobs.comDiversityJobs.com