Claims Handler

at  East Midlands Ambulance Service NHS Trust

Develop and maintain accurate and effective systems in respect of the Trusts claims management service (excluding motor and employment tribunal claims), in accordance with legal requirements and accepted good practice. Handle a caseload of claims, liaising with solicitors, insurance investigators, the NHS Resolution and other parties within and outside the Trust as appropriate. Investigate the circumstances of claims to support the Head of Governance, Senior Claims Handler, NHS Resolution or their solicitors and obtain the necessary documentation and explanations from staff across EMAS to support the Trusts position in responding to the claim. Highlight all new claims and claims progress to the Head of Governance or Senior Claims Handler, advising of any concerns or developments to ensure risk management action can be taken as necessary.
Accurately input claims information onto claims/disclosure spreadsheets and the Ulysses incident management system to record all activity relating to the claim. Implement the Claims Procedure within the Claims Team and across the Trust as required. Provide practical support and advice to managers and staff in relation to statement taking and/or investigation as appropriate to the complexity of the case. Prepare synopsis reports for clinical negligence and other claims as appropriate.
Process requests for disclosure of health records and other documents as requested by NHS Resolution, solicitors, or (potential or actual) litigants in person in accordance with the relevant legislation (Pre-action Protocol for Clinical Disputes, General Data Protection Regulations, the Data Protection Act, Access to Health Records Act). Prepare claims reports, including statistical and financial information, to support effective planning of the claims function and to identify areas of risk . Record and monitor the cost of claims and associated legal costs, reporting on expenditure and lessons learned. With the Head of Governance and Senior Claims Handler develop and maintain links between claims, complaints and risk management to ensure that learning can take place across the Trust.
Respond to enquiries received from outside bodies such as the NHS Resolution or solicitors. Liaise with key managers within the Trust to obtain information needed to investigate claims. Produce documentation to support payment requests and present to the Head of Governance for authorisation. Extract the appropriate information from the Claims database and Payments Tracker to create the month-end Finance Provision Reconciliation and work with the Finance team and NHS Resolution to resolve any queries.
Maintain a record of payment requests and authorisations. Attend meetings, seminars and training as necessary for the purpose of personal development and share learning with the team

Please refer the Job description for details