Job Description:

This position investigates, evaluates, handles and disposes of assigned claims to include: medical professional liability and general liability in a timely and cost effective manner in accordance with the client contract, general tort statutes/case law and company guidelines in multiple state jurisdictions or territories.  Also responsible to establish and maintain a partnership through occasional visits with client staff, defense attorneys, primary carriers and healthcare providers.

Overnight travel is required to attend mediations and trials.

 

 

ESSENTIAL DUTIES AND RESPONSIBILITIES

 

Responsible for handling and the disposition of the most severe and complex medical malpractice claims AND public officials, police professional, general liability, auto liability, and simple property claims.

 

Accurately and complete document claim file in order to justify all actions taken and to provide an audit trail.

 

Attend and participate in the claim committee review meetings.  Prepare and present claim committee review meeting evaluations and summaries.

 

Maintain a trial calendar for monitoring cases scheduled for trial and ensures that all trials, pretrial hearings, mediations and other conferences are attended and monitored as required.  Completes and prepares pretrial and trial analysis reports in accordance with client requirements.

 

Investigates and/or monitors case/claim activity to ensure a cost effective and appropriate claim strategy is developed in the best interest of the client and the healthcare provider.

 

Communicates tactfully and professionally in order to develop effective relationships with the client staff, defense attorneys, primary carriers and healthcare providers.

 

Initiates self-development and training to improve and maintain medical malpractice claim skills.

 

Effectively uses available automation on a regular basis and assumes responsibility for learning all available systems/software applicable to medical malpractice claims.

 

Assists with marketing presentations and other appropriate marketing activities.

 

May provide technical guidance to other members of the Medical Malpractice unit.

 

Eligibility and applicability responsibilities include:

 

Determining if the claim arose from rendering a professional medical service.

 

Determine MCARE statutory limits based upon the claim type and year.

 

Determine the dollar limit per occurrence or claim, and the annual aggregate.

 

Key claim handling tasks and responsibilities involve:

 

Contacting and coordinating with the client to investigate and secure information to render an independent analysis of the case, while investigating and securing information for analysis.

 

Request and obtain copies of all material and documents that are relevant to coverage and evaluations of liability and damages, expert report summaries, defense and settlement strategies.

 

Establish and adjust ongoing reserves.

 

Completion of anti-fraud forms.

 

Maintain a required diary and update the claim file with current coding information.

 

Prepare appropriate status reports.

 

Identify and evaluate exposure to substandard care, consent issues and causation and liability apportionment as it relates to each healthcare provider.

 

Gather information needed to index the plaintiff, evaluate the risk exposure to involved healthcare provider based upon coverage limitations and joint and several liability.

 

Evaluate the impact of an involved party executing a joint tort-feasor release.

 

Evaluate and utilize settlement techniques such as structure settlements, mediation, arbitration, high/low settlements.

 

Provide recommendations to client on suggested defense or settlement strategies.

 

Make recommendations and request settlement authority as appropriate.

 

Negotiate settlements in the best interest of the client.

Adopt a “united defense” and defense strategies that are in the best interest of the client.

 

Prepare file closure including information needed for the national Practitioners Data Bank.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.

Why Penn National Insurance/Inservco

·         A career with Penn National Insurance/Inservco offers a total rewards package that makes us a regional employer of choice.  When you are part of the Penn National Insurance/Inservco family, we want you to feel secure in:

 

·         Your Career: We offer a comprehensive benefit and compensation package including a generous 401k match, graded profit sharing, recognition programs, and incentive compensation.  Additionally, Penn National Insurance/Inservco company policy provides for remote access, flex-scheduling, and a dress-for-your-day dress code. 

 

·         Your Employer: Penn National Insurance celebrated its 100th anniversary in 2019.  With the $1 billion direct written premium threshold in sight, the company is utilizing innovation solutions and analytic insights to grow its share of the small commercial and middle market business, as well as personal lines.  Our proud tradition of adhering to a relationship-driven business model, and our ability to adapt to changes over time reinforce our reliability and strength.

 

·         Your Community: The Company and our employees donate more than $500,000 annually to fund enrichment programing throughout the communities we serve.  Our United Way campaign raised an additional $350,000 last year.  We are also taking real steps to decrease our environmental impact.  We have added bicycle accommodations, enhanced energy efficiency, introduced water conservation measures, and implemented cool-roof technology.

 

·         Your Future: We create a rewarding career path and enable long-term retention by offering enhanced benefits around continuing education and professional development.  The average employee tenure at Penn National Insurance/Inservco is 14 years!

 

Experience:

QUALIFICATIONS

 

Education/Credentials:

 

4-Year undergraduate degree (BS or BA); and a Jurist Doctorate degree in law from an ABA-accredited institution.

 

Minimum of 7-years in the medical malpractice insurance industry.

 

Comprehensive understanding of medical malpractice law and insurance policy coverage and claim practices.

 

Extensive knowledge of tort and state laws applicable to medical malpractice claims, PA Unfair Insurance Practices Act, medical malpractice policy coverage and provisions, the MCARE Act and medical and legal terminology.

 

Excellent negotiation skills.

 

Excellent research and analysis skills.

 

Good math aptitude, with the ability to develop and evaluate the values of the most severe and complex medical malpractice claims.

 

Excellent communication skills, both oral and written, with the ability to communicate on technical issues and operate in an environment of technological and legal change.

 

Excellent inter-personal skills.

 

Good PC skills, with an emphasis on Microsoft products.

 

Excellent organizational skills, with the ability to work independently.

JOB REQUIREMENTS (as required by ADA)

 

Must be able to operate a computer, keyboard, applicable printers and other general office equipment.

 

Specific vision abilities include close vision, distance vision, peripheral vision, depth perception and the ability to adjust focus.

 

Must have the ability to communicate effectively both orally and in written format.

 

Must be able to interpret and apply concepts based on established guidelines.

 

Must be able to access and enter information accurately, using automated systems.

 

Must be able to reach with arms and hands.

 

This position requires a combination of sitting, standing, walking, bending over, and climbing stairs throughout the day.

 

Must have a valid driver’s license and be able to operate a motor vehicle.

 

Must be able to travel, with some over-night stays possible.

 

Must be able to maintain acceptable attendance and adhere to scheduled work hours.

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