Risk Claims Management Coordinator Maitland FT Days at AdventHealth

Date Posted: 7/15/2021

Job Snapshot

  • Job Schedule
  • Location:
    Maitland, FL
  • Date Posted:
  • Job ID:
  • Job Family
    Physician Services
  • Shift
    1 - Day

Job Description

Claims Management Risk Coordinator AdventHealth Medical Group- Risk Management

Location Address: 2600 Westhall Lane, Maitland, FL 32751

Top Reasons to work at AdventHealth Medical Group

  • Faith based & mission driven organization
  • Central Florida’s premier multi-specialty medical group
  • Comprehensive Employee Benefits such as Educational Reimbursement
  • CREATION Health employee wellness and lifestyle programs
  • Positive working climate to support a work life balance

Work Hours/Shift: Mon-Thurs 8:30-5pm, Fri 8:30am-3pm

You Will Be Responsible For:

  • Notifies the Risk Management Administration regarding any specific risks to other AHMG patients, visitors, or staff, as identified through the management of claims
  • Organizes and manages medical malpractice subpoenas and depositions to include providing assistance/support to employees
  • Efficiently manages AHMG professional liability according to established protocols 
  • Protects the assets of AHMG through effective management of internal and AHS claims
  • Works cooperatively with AHS Risk Management and Defense Attorneys in the management of all AHMG and general liability claims for AdventHealth Medical Group
  • Monitors and investigates all potential claims, as appropriate
  • Works collaboratively with the Associate Director of Risk Management to resolve claims with patients in a timely and professional manner including, but not limited to: denial, negotiation, and/or settlement
  • Assesses liability, damages, and value of potential claims
  • Monitors and reports the following data related to AHS:  number of PCE’s and claims submitted, payouts and loss runs to ensure appropriate and timely payment of claims
  • Monitors, analyzes, and reports aggregate claims data to AHMG Executive Leadership under the direction of the Director of Risk Management as requested
  • Facilitates Amendment 7 and discover requests for claims are consistent with the intent of the Patient Safety and Quality Improvement Act


What You Will Need:

  • Associates degree, business or healthcare-related field OR
  • Minimum of two years of experience in Risk/Claims Management or Paralegal
  • Bachelor’s degree in business or healthcare related field, preferred
  • Active Florida State license as Health Care Risk Manager, preferred
  • Florida license in Risk Management, preferred
  • Florida Claims Adjuster, preferred
  • Understands medical technology and terminology, medical procedures/treatments, their usual risks, and expected outcomes. 
  • Understanding of conflict resolution and grievance management techniques.
  • Knowledge of federal legislation, state statutes, and case law relevant to risk management and patient safety activities.
  • Understanding of the claims/litigation prevention and management process. 
  • Proficient in computer software programs utilized in the department.

Job Summary:

The Claims Management Coordinator (CMC) is responsible for assisting in identifying claim related risks to Adventhealth Medical Group, its physicians, staff, and visitors.  The CMC ensures all AHS claims needs are handled in an efficient and timely manner and in compliance with established protocols.  The CMC maintains files and organizes internal claims issues of all AHMG internal claims with the collaboration of the Associate Director of Risk Management.  The CMC manages AHS insurance requests related to claims validation and physician malpractice renewals and changes.

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

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