Risk Management Claims Coordinator

OverviewNow hiring a Risk Management Claims Coordinator!Do you have experience in litigation support, law firm or business administration? This may be the ideal job for you!The Risk Management Claims Coordinator reviews legal documents to schedule and track Presbyterian's legal responsibilities. Must understand legal billing and accuracy. Orients staff in response to criminal and civil subpoenas for court testimony, pre-trial interviews and depositions. The Risk Management Claims Coordinator is the primary liaison for Judicial requests for subpoenas, law enforcement agencies, and other county/state/federal agencies). Set up claims, track expense and indemnity payments, reconcile payments to claim system. Supports litigation management functions for Risk department, including overall support for lawsuits and legal claims. Provides legal documents including certificates of insurance, verification of coverage, claim histories and other information for Central Verification Office, Health Plan and Provider Enrollment.How you belong matters here.We value our employees' differences and find strength in the diversity of our team and community.At Presbyterian, it's not just what we do that matters. It's how we do it - and it starts with our incredible team. From Information Technology to Food Services and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members.Why Join Us• Full Time - Exempt: No• Job is based Rev Hugh Cooper Admin Center• Work hours: Days• Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.Ideal Candidate:3-5 years relevant experience in law firm, litigation support, business administration, or similar. Requires knowledge of legal process, legal issues, data management and interpretation, and effective communication skills. Paralegal certificate preferred.Qualifications• High school diploma required; Bachelors degree preferred.• 3-5 years relevant experience in law firm, litigation support, business administration, or similar.• Requires knowledge of legal process, legal issues, data management and interpretation, and effective communication skills. Paralegal certificate preferred• Requires excellent organizational and people skills. Ability to deal with all levels of staff and management within the organization as well as the public and outside legal counsel under sometimes stressful conditions.• Must be proficient in Microsoft Office; ability to compile reports, graphs, letters, memos, and other related legal documents.• Notary Public preferredSkills• Able to work in a high volume, complex environment.• Assist in gathering data and completing insurance policy renewal applications, issue providers evidence of insurance certificates, complete requests for claim histories and insurance verification.• Maintain database of employees for individual evidence of insurance.• Manage and updates Legal claims case files in system.• Assist with annual budget preparation and tracking for Risk Management department• Works with highly sensitive information, so must be able to hold information in confidence.• Must be able to work rapidly and accurately under pressure with attention to detail.• Able to establish and maintain effective communications with all levels of employees, patient and families, physicians, attorneys, insurance professionals, and people in all aspects of the community and business affiliations.• Strong analytical, interpersonal and organizational skills.• Ability to multitask and work collaboratively with others and independently in order to accomplish goals.• Effective communication and presentation skills for all levels of the company.Education Essential: High School Diploma or GEDResponsibilities• Schedules, tracks, bills and orients PHS staff on legal process related to criminal and civil subpoenas for court testimony, pre-trial interviews and depositions; bills time and collects fees for PHS depositions as necessary.• Coordinates Court requests for subpoenas, law enforcement agencies, and other county/state/federal agencies) providing information, routine inquiries, etc.• Review, submit, track and follow up on all invoices submitted to Risk Management legal fees, insurance premiums, system services, settlements, medical bills, etc.• Document, review and process all Notary Applications for Presbyterian. Update PHS Notary list online• Claim set up, data entry and file management of all claims, notice of circumstance and litigation.• Develop and maintain positive and external customer relationships by coordinating with other departments or function areas to resolve customer problems when necessary• Continuously identify methods for automating processes and improving department efficiency• Coordinate and manage claim review meetings and Claims Authority Group meetings, other• Directs administrative functions for the Risk Department• Manages Risk Management intranet site• Composes confidential letters and memoranda from knowledge of department policy or procedures or from verbal direction from risk attorney or director• Resolves or triages information and inquiries from callers and visitors to the building, exercising judgment in screening and handling phone calls and visitors to the building, who are often very emotionally fragile or angry• Review legal and insurance bills for appropriate charges, code for accounting, and submit for approval and payment. Document, track and reconcile payments.• Anticipates and assists with PHS-wide insurance policy renewals and expirations. Assists with maintenance of insurance policies and coding accuracy in the Claims system• Collaborates with provider groups and HR to develop and maintain risk management profiles and insurance coverage on providers and integrates that information into the credentialing process in compliance with State and Federal agencies, Joint Commission and /or other accrediting bodies and PHS/PHP requirements• Responsible for data entry, organization of data and records related to professional liability, general liability, property and other insurance coverage types for Presbyterian Healthcare Services.• Litigation support including collection and review of information for responding to litigation discovery requests and documents requested by the team or outside counsel. Maintains Discovery (documents produced in litigation) library for consistent and accurate responses• Gathers data for billing, contractual, or licensure issues, and processes invoices for payment• Receives complaints and requests, and responds to telephone and walk-in inquiries regarding medical-legal and other legal liability situations, customer patient/family problems.• Maintains insurance invoices and log of premiums, adjustments and credits under each policy.• Maintains permanent insurance records and historical data in accurate and systemic manner for quick retrieval and verification of data.• Maintains original policies and related documents as per retention scheduleBenefitsAll benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.Wellness Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.Why work at Presbyterian? As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.About Presbyterian Healthcare Services Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.Inclusion and Diversity Our culture is one of knowing and respecting our patients, members, and each other. We capture this in our Promise and CARES commitments.AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.#NCS123Maximum Offer for this position is up toUSD $26.46/Hr.Compensation DisclaimerThe compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.Employment Type: FULL_TIME