Claims Analyst or Claims & Patient Safety Specialist at MIEC

Oakland, California, United States -

Full Time

Start Date

Immediate

Expiry Date

09 Mar, 26

Salary

149484.0

Posted On

09 Dec, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Claims Management, Patient Safety, Risk Management, Medical Malpractice, Customer Service, Analytical Thinking, Communication Skills, Research Skills, Healthcare Regulations, Clinical Systems, Data Analysis, Documentation, Negotiation, Collaboration, Problem Solving, Attention to Detail

Industry

Insurance

Description

Description Are you ready to make a real difference in healthcare? MIEC is searching for a dynamic Claims professional to join our passionate team and play a pivotal role in protecting medical professionals and advancing patient safety! Whether you step into the role of Claims Analyst or take on the expanded responsibilities of Claims & Patient Safety Specialist, you’ll be at the heart of our mission—opening, investigating, managing, and resolving incident and claim files for our valued policyholders. But that’s just the beginning! As an Analyst or Specialist in our Claims Department, you’ll go beyond claims management, partnering directly with groups and individual policyholders to deliver innovative Patient Safety & Risk Management services. You’ll help shape safer healthcare environments, drive impactful change, and become a trusted advisor to those who count on us most. Join MIEC and be part of a team that’s redefining excellence in claims and patient safety—where your expertise, initiative, and commitment truly matter. Get a sneak peek into MIEC’s mission-driven, collaborative culture by following this link. LOCATION: This position is remote, with a preference for candidates located in Southern California, with limited travel to our main office in Oakland, CA. This position requires some travel from time to time, including overnight stays. COMPENSATION: The hiring salary range of $73,050 to $149,484 will be based on role, experience, and location. Priority will be given to candidates in Southern California, but see hiring ranges below for all locations: Hiring range for Claims Analyst role: San Francisco Bay Area and Hawaii: $84,519 to $112,691 All other locations: $73,050 to $97,400 Hiring range for Claims & Patient Safety Specialist role: San Francisco Bay Area and Hawaii: $112,113 to $149,484 All other locations: $96,900 to $129,200 MIEC offers competitive compensation, commensurate with experience and a comprehensive benefits package. MIEC is an EEO employer; we enjoy diversity in our staff, policyholders and business partners. BENEFITS: 401(K) + Pension Plan Health Insurance Vision and Dental Insurance Generous Paid Time Off Plans WHAT YOU’LL DO: Whether hired as a Claims Analyst or a Claims & Patient Safety Specialist, your primary duties will be in Claims, where you will: Respond to first notice of potential claims from policyholders and handle advice calls, gathering preliminary information and providing appropriate advice for action. Collaborate with the Claims team to identify and evaluate insurance coverage issues, and to develop, prepare and implement appropriate negotiation/case resolution strategies. Obtain and review records, interrogatories, depositions, consultant reports, and attorney reports; coordinate discovery with defense counsel; monitor file status, reserves, legal landmarks and billings. Prepare documentation, reports, and correspondence with policyholders, claimants and attorneys. Submit incident, claim and suit files for opening; manage and close files in a timely manner. Exercise strong judgment in settling cases within authority and develop indemnity and expense reserve recommendations above defined authority level. Study trends and current developments within the medical malpractice industry in the states in which MIEC operates, and nationally. Proactively share information within the department about the trends and current developments, including relevant court cases. Participate in seminars, trainings, meetings, and Board meetings, when requested. If hired as a Claims & Patient Safety Specialist, you will also: Collaborate with MIEC’s Patient Safety & Risk Management (PSRM) staff to provide specialized internal and external services addressing existing member groups and new business, including large medical groups and hospitals. Apply principles of healthcare risk management, such as incident reporting and investigation, risk analyses, and policies/procedures, to further develop PSRM services which can be applied in all healthcare settings. Collect, analyze, and compare MIEC data to present evidence-based information to members, utilizing data from various healthcare and medical malpractice claims sources including Candello - Solutions by CRICO, the MPL Association Data Sharing Project, and Preverity. Coordinate and conduct Claims Prevention Surveys for policyholders. Manage active matters involving unanticipated patient harm through MIEC’s RESTORE communication and resolution program; work with MIEC policyholders to support effective patient communication, disclosure, and/or apology discussions. Effectively research, write, and edit patient safety and risk management articles, newsletters, and other written materials. Participate in the conception and completion of special projects. Requirements WHO YOU ARE: An experienced team member with a demonstrated expertise in the handling of medical malpractice claims and a solid understanding of Patient Safety Risk Management (PSRM) services and products, and the ability to address general PSRM questions or refer to the appropriate discipline. A flexible collaborator who has a demonstrated customer service focus with all levels of internal and external stakeholders. An enthusiastic and self-directed contributor who is skilled at managing multiple priorities with great attention to detail, within time-sensitive deadlines. An inquisitive analytical thinker with good judgement, professional initiative, and strong research skills. An excellent communicator, with strong written, verbal, and interpersonal communication skills and ideally with proficiency in medical terminology. Additionally, a candidate hired for the Claims & Patient Safety Specialist role would need: An understanding of clinical systems. Knowledge of hospital policies and procedures, and governmental healthcare regulations. Ability to analyze medical records and quality issues. WHAT YOU’LL BRING: Education: A Bachelor’s degree (BA/BS) is required. Licenses/Certification: A valid driver’s license is required. A Certified Professional in Healthcare Risk Management (CPHRM) designation is preferred. Experience: The ideal Claims & Patient Safety Specialist candidate will join us with a minimum of seven (7) years of experience as a medical professional liability claims representative, risk manager or similar experience in defense of medical professional liability or risk management/patient safety field required. The ideal Claims Analyst candidate will join us with a minimum of five (5) years of experience handling medical professional liability claims or professional-level experience in the legal industry. Digital Skillsets: Our ideal candidate will be a digitally fluent contributor, comfortable in a range of virtual environments and proficient with office software including Word, Excel, Power Point, Windows, Teams, Sharepoint, CoPilot, and paperless document management programs. About MIEC: MIEC was founded in 1975 in the depths of the malpractice crisis by physicians and their medical societies when insurance was largely unavailable to the healthcare community. As the West’s first truly physician-owned medical professional liability insurer, MIEC has always been guided by the desire to protect physicians and other healthcare professionals from malpractice risks and committed to a long-term philosophy of business conduct that ensures such a crisis never happens again. We exist to foster enduring partnerships within the healthcare community by serving members through a philosophy of vigorous protection and high value, delivered by people who care. As a member-owned exchange Headquartered in Oakland, CA, MIEC now insures more than 7,400 physicians and other healthcare professionals in 4 states, with regional claims offices in Idaho, Alaska, and Hawaii. MIEC has consistently adapted to meet the changing needs of healthcare delivery and continually seeks to reinvent medical professional liability through effective partnership, innovative insights, and dynamic risk solutions.

Responsibilities

The primary duties include responding to claims, collaborating with the claims team, and managing incident and claim files. Additionally, the Claims & Patient Safety Specialist will provide specialized services and conduct claims prevention surveys.