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The Claims Services Program is part of Risk Services, reporting to Compliance and Risk Services. Compliance and Risk Services protects the University from the financial impact of accidental loss and provides services to all University schools, colleges, and administrative units in the areas of risk financing, workers' compensation, discrimination complaint investigation, risk consulting, claims management, strategic loss control, and compliance support.
Claims occur most frequently in the areas of workers' compensation, automobile, general liability, employment practices, and professional liability, with lower frequency in marine protection and indemnity and first party property claims. The Claims Services staff manages claims in accordance with applicable laws and regulations and pursuant to the delegations granted to the department through the Standing Orders of the Board of Regents.
We have an outstanding opportunity for a Claims Operations Analyst to provide support primarily for the medical malpractice claims program and provides valuable services to support our clients in UW Medicine.
Under the general direction of the Assistant Director, the Claims Operations Analyst will assist the Claims Services Program staff in the management of claims and lawsuits managed by the Office by facilitating the gathering, disbursement, and management of various records needed particularly in the healthcare claims/litigation process. The position also will provide additional specialized support related to the legal, regulatory, and policy requirements of healthcare and other complex claims as outlined below. This position is a critical part of the risk management function at the University and its Medical Centers. This position supports the Claims Services Program's mission to share pertinent information in a meaningful constructive way to avoid, reduce, and mitigate risk.
This position requires technical competence, understanding of applicable policies, law, and regulations, and the savvy ability to communicate as a productive partner. This position must be focused on generating information from multiple data sources and effectively communicating to leadership with requests for information. Research and analysis is required on all cases, followed by the application of subjective judgment to assist in moving claims toward resolution through a variety of strategies. This position requires the application of strategic criteria in developing and organizing the claims handling process so that proper documentation is obtained to support claims resolution and/or litigation. The position also includes mining data for trends and lessons-learned, quality control checks for regulatory and data entry compliance, and support of various claims processes for complex claims.
The position assists the University and its covered affiliates in the management of claims and litigation by collaborating with a wide variety of University and non-University stakeholders at almost all levels on healthcare professional liability and other complex claims. The position facilitates the Claims Services Program's management of claims and lawsuits and supports providers and others who are adversely impacted by the stress of claims and lawsuits. Through this position's expected attention to detail and tenacity on records issues and other components, claims and litigation outcomes are expected to be enhanced and regulatory risks reduced, contributing to a lower premium under the University's self-insurance program and lower costs for the University.
Duties and Responsibilities:
Assist the Claims Services Program staff in gathering, disbursement, and management of various records to support healthcare professional liability and other complex claims. This includes medical records and all related records (imaging, monitoring, psych, etc.), personnel/employment files of physicians and others, policies and procedures, manuals, incident logs, etc. This also includes issuing litigation hold notices and releases, tracking records, and gathering and disbursing records to others to support the discovery process.
Communication Support on Claims/Lawsuits: Supporting the Claim Review Committee Process by communicating with key providers and attendees, pre-trial communication with key players, key player communication support.
Regulatory Compliance Support: Ensuring compliance with various reporting agencies (CMS, OIC, DOH, NPDB, and others) by completing reports and/or ensuring reports are done.
Malpractice Claim Histories and Credentialing Inquiries: Completing claims histories; fielding questions from providers; developing and maintaining efficient process for same.
Information/Data: Provide information to Assistant Director and Director and others upon request related to claims and litigation trends and lessons learned.
Facilitate the indemnification and defense process for University employees, students, and agents; handle matters covered under Chapter 5 Section 8.
Other claims/litigation support and special projects as assigned by the Assistant Director/Director.
Bachelor's degree and a minimum of 5 years of experience in one or more of the following: paralegal, medical training or background
Excellent written and oral communication skills with ability to communicate effectively with diverse audiences
Ability to analyze, interpret, and apply complex rules and regulations toward effective problem solving
Ability to effectively and efficiently use computer systems and databases
Demonstrated customer service skills
Strong planning and organization skills
Equivalent education/experience will substitute for all minimum qualifications except when there are legal requirements, such as a license/certification/registration.
Experience working in public university or agency
Employment Law experience or background
Conditions of Employment:
Appointment to this position is contingent upon obtaining satisfactory results from a criminal background check.
As a UW employee, you will enjoy generous benefits and work/life programs. For a complete description of our benefits for this position, please visit our website, click here.
Application Process: The application process for UW positions may include completion of a variety of online assessments to obtain additional information that will be used in the evaluation process. These may include Work Authorization, Criminal Conviction History, Cover Letter and/or others. Any assessments that you need to complete will appear on your screen as soon as you select Apply to this position. Once you begin an assessment, it must be completed at that time; if you do not complete the assessment, you will be prompted to do so the next time you access your My Jobs page. If you select to take it later, it will appear on your "My Jobs" page to take when you are ready. Please note that your application will not be reviewed, and you will not be considered for this position until all required assessments have been completed.
Founded in 1861, the University of Washington is one of the oldest public institutions in the west coast and one of the preeminent research universities in the world. The University of Washington is a multi-campus university comprised of three different campuses: Seattle, Tacoma, and Bothell. The Seattle campus is made up of sixteen schools and colleges that serve students ranging from an undergra...duate level to a doctoral level. The university is home to world-class libraries, arts, music, drama, and sports, as well as the highest quality medical care in Washington State and a world-class academic medical center. The teaching and research of the University’s many professional schools provide undergraduate and graduate students the education necessary toward achieving an excellence that will serve the state, the region, and the nation. As part of a large and diverse community, the University of Washington serves more students than any other institution in the Northwest.