MPL Career Center

MIEC: Claims Analyst

Company Background

We are Medical Insurance Exchange of California (MIEC), an insurance company that provides medical professional liability insurance to physicians and acupuncturists in Alaska, California, Hawaii and Idaho. We are owned and operated for the benefit of our policyholders, which number almost 7,400.

We were founded in 1975 by physicians during a time when commercial carriers withdrew from the market. Now, some 40 years later, we remain determined to provide our policyholders with low, responsible and stable premiums.

The Opportunity

This is a Medical Professional Liability Claims position. Under the direction of the Vice President of Claims & Patient Safety and the supervision of the Claims & Patient Safety management, this exempt position has primary responsibility for opening, investigating, managing, and closing incident and claim files arising against MIEC insureds.

Key Duties and Responsibilities

• Gathers preliminary information and provides appropriate advice for action. Documents file, and prepares reports and letters to insureds. Works with supervisor to determine follow-up: may contact plaintiff and/or defense attorneys.
• Responds to first notice of potential claims from insureds.
• Works closely with supervisor and management team as necessary to identify and evaluate insurance coverage issues.
• Submits incident, claim and suit files to supervisor for opening.
• Sets and raises expense reserves as needed within authority (maximum $100,000 combined indemnity and expenses) and makes indemnity reserve recommendations.
• Identifies, interviews and prepares reports on individuals pertinent to a case. Also prepares reports which outline the medical and legal case status and analysis, including Supplemental Reports, Case Development Memos, Case Summaries, Pre-Trial Reports and others as needed. Obtains and reviews records, interrogatories, depositions, consultant and attorney reports, coordinates discovery with defense counsel, monitors file status and reserves, legal landmarks and billings, documents all activity, and arranges peer review and attends peer review meetings.
• Works closely with supervisor and management team as necessary to develop, prepare and implement appropriate negotiation/case resolution strategies, can resolve claims within authority level.
• Has settlement authority up to $100,000. Responsible for informing management of all statutory offers and/or demands before responding.
• Performs court checks, orders settlement checks, prepares National Practitioner Data Bank and any state-mandated reports in consultation with insured and defense counsel, responsible for post settlement reporting as outlined in the Claims Manuel, prepares and reviews releases, notifies insureds regarding file closure, and authorizes final billings. Closes Incident, claim and suit files, independently
• Participates in seminars and meetings as appropriate, and special projects as assigned.
• Solid understanding of Patient Safety Risk Management (PSRM) services and products with ability to address general PSRM questions or refer to the appropriate discipline
• Participate in the design, logistical planning and presentation of seminars and webinars on a variety of Patient Safety and/or Risk Management topics (this may include speaking to groups from ten to 200 in size, from one to four hours in length)
• Develop, train and participate in Claims Prevention Surveys for healthcare providers of assigned groups for the purpose of evaluating risk (duties include: records reviews, presentations to doctors and staff, and writing an original exist report to be forwarded to Underwriting Department and group administration). Service can be used to evaluate potential participants and existing physician practices managed by the group.
• This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Qualifications

• NOTE: Only those with Medical Professional Liability Claims experience will be considered for this position.
• Strong written, verbal and interpersonal communication skills.
• Experienced in PC Windows applications and able to work with paperless claim management system.
• Ability to work independently, exercise good judgement and show professional initiative.
• Strong research and analytical skills; inquisitive.
• Ability to maintain confidentiality.
• Organized and detail oriented and capable of setting and meeting work related deadlines.
• Flexible, able to manage pressure and conflicting schedules
• Exercises independent judgement commensurate with experience and training.
• Maintain a valid driver's license

Education/Experience

• College degree or equivalent work experience in insurance.
• 5+ years handling medical profesional liability claims or legal background in medical professional liability; proficiency in medical terminology a plus.

Environmental/Physical Requirements

Position requires mild to moderate physical activity, and some travel required.

Location

• Headquarters is located in Oakland, California, with satellite offices in AK, HI, and ID.
• This position is a combination of remote & onsite work in California or Idaho.
• Due to COVID conditions this position will primarily be remote until at least April 30, 2021.

Hours

This position will work regular Pacific Time (PST) business hours, regardless of the employee's location.

Benefits

• 401(K)/Pension Plan
• Health Insurance
• Vision and Dental Insurance
• Paid Time Off

Compensation

Salary based on experience.
MIEC offers competitive compensation commensurate with experience and a comprehensive benefits package.
MIEC is an EEO employer, we enjoy diversity in our staff, insured and our business partners.

How to Apply

Please apply for the position via LinkedIn.

Contact Name

Shazia Chaudry

Contact Email

Recruiting@miec.com