Claims Administrator

Job Location: Philadelphia, Pennsylvania

About the role

The primary function of this position is to coordinate the essential administrative functions related to Penn Medicine’s professional liability claims management including responsibility for maintaining a comprehensive claims database, preparing reports for actuaries, excess carriers and internal stakeholders, handling the opening and closing of claims and recording of reserves, and managing data requests. This position likewise supports the claims management team in all aspects of claims management.

Responsibilities

• Maintaining comprehensive claims database including responsibility to input and update information on claims including reserves, and reporting of potential claims to insurance carriers.
• Coordinating claims set-up including contact with filing party, verification of insurance coverage, data entry to record new claim, and submission of State Board letters.
• Managing responses to all claims data requests from brokers, auditors, excess carriers, and actuaries.
• Prepares reports, charts and print-outs with respect to claims and loss experience.
• Assist with and validates weekly check run for indemnity payments and vendor payments.
• Assist in all aspects of claims management including participation in reserving process, updating reserves, closure of cases including managing any requisite CMS reporting.
• Serves as liaison to database software vendor and internal information services.
• Assist with acceptance of service and responds to internal inquiries regarding information requests and subpoenas related to claims or potential claims.
• Provides assistance to risk management staff as needed to meet the goals of the risk management program.
• Other duties and responsibilities as assigned.

Qualifications

• BA/BS and 3-5 years of experience, or an equivalent combination of education and experience required.
• Possess ability to work independently, manage time effectively & use sound judgment.
• Sensitivity in handling confidential materials; strong verbal & written communication skills.
• Strong attention to detail skill, must be well-organized, self-starter with the ability to take initiative & find solutions to complex situations.
• Ability to prioritize work & have ability to meet simultaneous deadlines.
• Strong proficiency in Microsoft Office software applications, with particular emphasis on Access, Word, & Excel & ability to learn new software programs.
• Preferred: Experience in a hospital legal office or insurance claims management office.
• Preferred: Experience with Origami and iManage or similar programs.

Benefits

• Health, Life, and Flexible Spending Accounts: Penn offers comprehensive medical, prescription, behavioral health, dental, vision, and life insurance benefits to protect you and your family’s health and welfare. You can also use flexible spending accounts to pay for eligible health care and dependent care expenses with pre-tax dollars.
• Tuition: Take advantage of Penn's exceptional tuition benefits. You, your spouse