Claims Examiner or Claims Analyst (DOE)
Fully Remote Work-from-Home, HI Claims Department
Job Type
Full-time
Description

LOCATION

This position will be remote, working from home in Hawaii. 


POSITION SUMMARY 

This position could be for an  a Claims Examiner or a Claims Analyst , depending upon the experience the candidate brings. This role has primary responsibility for opening, investigating, managing, and closing incident and claim files arising against MIEC policyholders. 


COMPENSATION 

Exempt/Salaried (Hiring ranges for Hawaii)

  • Claims Examiner ($72,221 to $96,294)
  • Claims Analyst ($88,163 to $117,551)

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 business partners.


BENEFITS

  • 401(K)+Pension Plan
  • Health Insurance
  • Vision and Dental Insurance
  • Generous Paid Time Off Plans

ESSENTIAL FUNCTIONS 

  • Responds to first notice of potential claims from policyholders and handles advice calls.
  • Gathers preliminary information and provides appropriate advice for action. 
  • Works closely with managers and team to identify and evaluate insurance coverage issues.
  • Processes incident, claim and suit files, keeping management informed of all statutory offers and/or demands. 
  • 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 file, prepares reports, and drafts correspondence to policyholders, claimants, and attorneys.
  • Works closely with supervisor/manager and management team to develop, prepare and implement appropriate negotiation/case resolution strategies; resolves claims within defined authority level.
  • Performs court checks, orders, and approves settlement checks; prepares state-mandated reports; prepares and reviews releases; notifies policyholders of file closure; reviews and clears billings. 
  • Participates in seminars, training, meetings, and Board meetings, when requested. 

 Additionally for a Claims Analyst role: 

  • Participates in settling cases. 
  • Responds to general Patient Safety Risk Management (PSRM) questions from policyholders.
  • Participates in the design, planning and presentation of seminars and webinars.
  • Studies trends and current developments within the medical malpractice industry.
  • Trains and participates in Claims Prevention Surveys for policyholders for the purpose of evaluating risk.
Requirements

Education:

  • Bachelor’s degree (BA/BS) required.

Licenses/Certification:

  • A valid driver’s license is required.

Experience:

Amount of experience required depends on the requirements for the position being interviewed for (Examiner through Analyst).  

  • An Examiner role requires no prior professional experience
  • An Analyst role requires a minimum of five (5) years of prior experience handling medical professional liability claims or professional-level experience in the legal industry. 

Knowledge/Skills/Abilities:

  • Solid understanding of Patient Safety Risk Management services and products; ability to address general PSRM questions or refer appropriately.
  • Strong written, verbal, and interpersonal communication skills; ability to work with diverse audiences.
  • Customer service focus and commitment to policyholders.
  • Ability to work effectively independently and as a member of a team.
  • Strong research and analytical skills; inquisitiveness.
  • Strong organizational and time management skills.
  • Proficient with computers and software including Word, Excel, Power Point, Windows, Teams, Sharepoint and paperless document management programs.
  • Willingness and ability to travel with overnight stays, as needed.

Additionally for a Claims Analyst role:

  • Demonstrated expertise in the handling of medical malpractice claims.
  • Proficiency in medical terminology preferred.


About MIEC:

MIEC was founded in 1975 in the depths of the malpractice crisis by physicians and their medical societies when insurance was largely unavailable to the healthcare community. As the West’s first truly physician-owned medical professional liability insurer, MIEC has always been guided by the desire to protect physicians and other healthcare professionals from malpractice risks and committed to a long-term philosophy of business conduct that ensures such a crisis never happens again. We exist to foster enduring partnerships within the healthcare community by serving members through a philosophy of vigorous protection and high value, delivered by people who care.As a member-owned exchange Headquartered in Oakland, CA, MIEC now insures more than 7,400 physicians and other healthcare professionals in 4 states, with regional claims offices in Idaho, Alaska, and Hawaii. MIEC has consistently adapted to meet the changing needs of healthcare delivery and continually seeks to reinvent medical professional liability through effective partnership, innovative insights, and dynamic risk solutions. 

Salary Description
Hiring range: $72,221 - $117,551 DOE