Claims Manager

Aya Healthcare Inc.
United States
Remote

Who this role is best for

Claims professionals with medical malpractice expertise and multi-jurisdictional experience will find this remote role emphasizes collaboration with legal and insurance teams.

Best fit for

  • Candidates with 3+ years in professional liability claims and familiarity with medical terminology
    — “3+ years prior experience in Professional Liability claims adjusting”
  • Individuals comfortable with litigation, settlement negotiations, and working with outside counsel
    — “Work regularly with outside counsel and insurance representatives”
  • Professionals who can manage high-volume workloads and apply technology to streamline processes
    — “Ability to work in fast-paced environment with large volume of matters”

Things to consider

  • The role involves regular attendance at mediations and trials, which may require travel or in-person work
    — “Attend mediations and trials”
  • Candidates must be prepared to handle claim investigations and review compensability determinations
    — “Assist with claim investigations, monitor compensability determinations”

How to stand out

  • Highlight experience managing litigated claims and successful settlement outcomes in your resume
    — “Evaluate claim action plans and overall file quality to help achieve optimal claim outcomes”
  • Emphasize your ability to collaborate across legal, medical, and insurance teams
    — “Collaborate with specialty resources (medical and legal) to proactively pursue claim resolutions”
  • Showcase your knowledge of claim handling policies and procedures in your application materials
    — “Strong knowledge of claim handling policies and procedures”
Pace · Fast PacedCollaboration · HighAutonomy · MediumDecision Impact · Team

Derived from job-description analysis by Serendipath's career intelligence engine.

What success looks like

  • manage active and litigated claims
  • work with outside counsel
  • analyze settlement authority requests
Typical background
claims managementlegal experience

Skills & requirements

Required

Professional Liability Claims ManagementLitigationSettlement Negotiations

Preferred

TPA ExperienceMedical Terminology

Stack & domain

Professional Liability Claims AdjustingMedical Malpractice ClaimsLitigationSettlement NegotiationsCommunicationStakeholder ManagementData-driven Decision-makingClaims ManagementHealthcareLegal

About the role

Original posting from Aya Healthcare Inc.

Join Aya Healthcare, winner of multiple Top Workplace awards!

The Claims Manager will analyze and manage professional liability/medical malpractice claims, under the direction and supervision of Senior Corporate Counsel.

Who We Are: 

We’re an $8+ billion, rapidly growing workforce solutions provider in the healthcare industry. We deliver tech-enabled services that help healthcare organizations meet and manage their contingent labor needs. We build and manage tech-enabled marketplaces for national and local healthcare talent and deliver contingent labor management solutions through our proprietary software platform.  

At Aya, we’re obsessed with creating exceptional experiences for our clients, clinicians, and employees. In fact, we put employee satisfaction above all else. Our team members are responsible for incomparable customer experience and we know that happy employees are critical to maintaining happy clients. We foster an entrepreneurial, high-energy, low-bureaucracy culture and value innovative thinking and creative problem solving. We embrace diversity in thought and backgrounds unified by a commitment to high achievement. When you join Aya, you’ll be surrounded by teammates who care about you as an individual and leaders who will help you grow both personally and professionally. 

Responsibilities: 

Manage active and litigated Professional Liability claims – track, review, analyze, and update Corporate Counsel on all open matters.

Assist with claim investigations, monitor compensability determinations and review with outside counsel when necessary. Evaluate claim action plans and overall file quality to help achieve optimal claim outcomes.

Work regularly with outside counsel and insurance representatives to obtain up to date claim information and to analyze and approve investigation and reserve requests.

Ensure compliance with state regulatory rules and requirements.

Collaborate with specialty resources (medical and legal) to proactively pursue claim resolutions, and analyze settlement authority requests. 

Attend mediations and trials.

Regularly meet with Corporate Counsel to review claims and discuss claim strategy.

Qualifications:

3+ years prior experience in Professional Liability claims adjusting

JD preferred

Ability to work in fast-paced environment with large volume of matters

Strong knowledge of claim handling policies and procedures

Knowledge of medical terminology

Familiarity with claims in multiple jurisdictions

Experience working with a TPA

Experienced in litigation and settlement negotiations

Intermediate knowledge of PL products and ability to apply available resources and technology to resolve claims and streamline the claim process

What We Offer: 

Free premium medical, dental, life and vision insurance 

Generous 401(k) match 

Aya also offers other benefits to those that are eligible and where required by applicable law, including reimbursements and discretionary bonuses 

Aya provides paid sick leave in accordance with all applicable state, federal, and local laws. Aya’s general sick leave policy is that employees accrue one hour of paid sick leave for every 30 hours worked. However, to the extent any provisions of the statement above conflict with any applicable paid sick leave laws, the applicable paid sick leave laws are controlling 

Celebrations! We hit our goals and reward ourselves.  

Company-sponsored virtual events, happy hours and team-building activities are always on the horizon — plus, you get a special treat on your birthday! 

Unlimited DTO — we believe in time off!  

Virtual yoga, meditation or boot camp classes offered daily 

Compensation: Aya reasonably anticipates the pay scale for this position to be an annual salary of $100,000 to $125,000.  

The pay scale for this position may vary if applicant possesses experience outside of what Aya reasonably anticipates for this position. Bonuses are subject to the role and your manager’s discretion. 

Aya is an Equal Opportunity Employer (EEO), including Disability / Vets, and welcomes all to apply. Please click here for our EEO policy.

Source: Aya Healthcare Inc. careers

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