Quick overview
SeniorityMid Senior
Work modeRemote
LocationSaint Louis, United States
Risk ManagementTriage
Job description
- Location: Remote
- Department: Risk Management
- Schedule: Full-time
- Eligible for an annual bonus incentive
#LI-Remote
- Supervise, mentor, and professionalize a team of 4 - 5 Claims Specialists and Senior Claims Specialists across designated regional territories.
- Conduct regular performance evaluations, claim file audits, and quality assurance reviews to ensure operational excellence and adherence to departmental guidelines.
- Act as the primary gatekeeper for all incoming claims, notices, and incident reports within assigned regions, executing structured rotational workload distribution and preliminary claim triage.
- Provide expert technical guidance on coverage analysis, liability assessment, complex reserve evaluations, and defense strategies across HPL, PPL, and GL claims.
- Facilitate and participate in regular claims review sessions with hospital executive leadership, clinical leaders, and local risk personnel to discuss emerging exposures and high-severity files.
Licensure / Certification / Registration
- Required Credential(s):
- None Required.
Education
- High School diploma equivalency with 2 years of cumulative experience OR Associate's degree/Bachelor's degree with 1 year of experience OR 5 years of applicable cumulative job specific experience required. 2 years of leadership or management experience preferred.
Additional Preferences:
- 5 to 10 years of progressive management and supervisory experience in complex liability claims handling; Juris Doctor (JD) degree or Bachelor's degree with equivalent extensive experience in Healthcare Professional Liability (HPL), Physician Professional Liability (PPL), and General Liability (GL).
- CPHRM, CPCU, or applicable state adjuster licenses preferred.
- Proficiency in modern claims platforms including Riskonnect, STARS, and CMS reporting environments.
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