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Northwell Health

Nonprofit health system in New York and Connecticut

Claims Management Counsel

Legal Counsel & Legal SupportConfirmed live in the last 24 hours
Full-time$105.4k - $183k /yrIn-person

About the Job

Requirements

  • A Juris Doctor is required.
  • One to three years of relevant experience is required.
  • Residing in the New York or Connecticut area is preferred.

Responsibilities

  • Participate in managing a Claims Management Program by prioritizing and monitoring filed claims, evaluating insurance coverage, ensuring claims are reported to primary and excess insurance, conducting or monitoring claims audits, evaluating and monitoring reserves, and overseeing defense counsel.
  • Monitor a comprehensive, integrated system for managing non-workers’ compensation claims for the organization and its affiliates, and assist in managing an assigned claims caseload.
  • Ensure claims are reported to insurance carriers and conduct insurance coverage analyses.
  • Review and evaluate insurance carrier coverage responses, including reservations of rights and coverage denials; evaluate loss runs to ensure adequate reserves at all layers of primary and excess coverage.
  • Oversee third-party claims and defense counsel in all aspects of assigned claims, including day-to-day management, case reserves, expenses, and motion practice; maintain current claim information in the database.
  • Ensure appropriate expert reviews and evaluate claims for exposure, severity, reserves, and trial dates.
  • Monitor cases on trial and attend trials when necessary; identify cases requiring early or pre-trial resolution.
  • Collect and review claims data to identify trends and loss-control opportunities; collaborate with risk management to recommend loss-control initiatives.
  • Serve as a liaison among the organization, the Third Party Claims Administrator, and the Insurance Broker on claims management; monitor claims affecting the health system’s insurance captive, self-insurance program, and/or deductibles; review insurance and related provisions of written agreements.
  • Work under general guidance on varied assignments requiring interpretation and independent decisions about the course of action.
  • Perform related duties as required.

About the Company

Northwell Health

Nonprofit health system in New York and Connecticut

Northwell Health is a nonprofit health system serving patients across New York City, Long Island, the Hudson Valley and Connecticut through hospitals and outpatient practices. Its network combines hospitals for complex care, community hospitals and specialty centers such as Cohen Children's Medical Center and Zucker Hillside Hospital. The system coordinates hospital, ambulatory and post-acute care, with philanthropy supporting its community mission. Its research institutes and partnerships with Hofstra University connect patient care with medical discovery and training for doctors, nurses and physician assistants. Founded in 1997, Northwell is headquartered in Lake Success, New York.

Company size
10,001+
Company stage
Not listed
Total funding
Not listed
Headquarters
Lake Success, NY
Founded
1997

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