National Healthcare Professional Liability -Senior

at Aon in Chicago, Illinois, United States

Job Description

National Healthcare Professional Liability -Senior Claims Consultant - Remote United States
Job Responsibilities:
Understanding client needs and programs
Identify Healthcare client HPL exposures via quantitative loss analyses, qualitative reviews, discovery sessions with client stakeholders to provide consulting advice and services designed to mitigate exposures and drive operational improvement for clients.
Improve client HPL claims management programs by examining and analyzing program elements and build best practice-oriented approaches to claims cost containment.
Conduct and support risk, clinical quality, and safety process assessments with a focus on operational improvement and financial exposure mitigation; deliver virtual, onsite visits and reports summarizing findings and recommendations.
Aon is in the business of better decisions
At Aon, we shape decisions for the better to protect and enrich the lives of people around the world.

As an organization, we are united through trust as one inclusive, diverse team, and we are passionate about helping our colleagues and clients succeed.

What the day will look like:
Client Advocacy
Provide advocacy on behalf of assigned clients relating to services rendered by carriers and/or TPAs to include the review and revision of account instructions, addressing client service concerns and negotiating applicable renewal pricing and terms. Ensure the highest level of service from HPL claims administrator(s).
Participate in telephonic or in-person claim reviews designed to result in resolution, inclusive of documenting claim specific outcomes, action plans and the appropriateness of reserving.
Coordinates settlement approval of HPL claims with designated client contacts.
Coordinates with legal counsel and other personnel involved in claims management and participate in final approval to defense strategies.
Advises clients regarding payment approval of fees including defense counsel and payment of other expenses of claims defense
Program Consultation
Work collaboratively within teams including risk control, ergonomic and casualty claims staff to execute initiatives for pre and post loss strategies.
Coordinates and consults with clients regarding appropriate reporting to all required outside agencies
Consults with clients in the following claims management program elements:
Reporting procedures
Investigation procedures
Claim Reserving
Use of alternative dispute resolution mechanisms
Monitoring of legal counsel
Patient communications, to include claimants, attorneys, physicians, employees, brokers and consultants
Claim settlements
Claims coding taxonomy
Compliance with Medicare/Medicaid case reporting regulations
Business and Administrative
Participate in periodic on-site client meetings regarding service delivery and stewardship.
Establish project plans and budgets.
Participate in business development opportunities as needed; articulate value propositions.
Meet assigned billable hour utilization goals

Skills and experience that will lead to success
Ability to interpret a variety of data (loss information, statistics, quality reports, CMS data, etc.) to create strategic and tactical improvement plans.
Solid technical background in exposures, controls and best practices in healthcare, including acute care, long term care, assisted living, behavioral health, ambulatory care, physician office practices.
Detailed understanding of "batch" HPL claims and ability to work with clients to manage the claims process
Understanding of jurisdictional variances across the country
Working knowledge of the Safe Medical Device Act (SMDA)
Familiarity with healthcare accreditations and quality scores, such as CMS Environment of Care Standards (EOC), Joint Commission EOC Standards, DNV EOC Standards, OSHA Standards applicable to healthcare, Working knowledge of Patient Safety Organizations (PSO)
Familiarity with HPL insurance markets and attendance at meetings and market symposiums.
Ability to establish rapport and maintain positive working relationship with clients and colleagues.
Possess excellent written, verbal and presentation communication skills.
Can work effectively on multiple tasks at any given time with minimal supervision and with deadlines
Proficiency in computer applications and data management tools (Share Point, Microsoft applications)
Travel: Approximately 25%

Required Experience: 10 years of experience as an accredited claims professional, additional credentials such as a registered nurse or 5 or more years in the safety/risk management... For full info follow application link.

Aon provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, creed, sex, sexual orientation, gender identity, national origin, age, disability, veteran, marital, or domestic partner status. Aon is committed to a diverse workforce and is an affirmative action employer.