Registered Nurse- Risk Management-Training Available

Risk Control Coordinator / Investigator.

Looking for a change? Work from 9 to 5, Monday through Friday as a CLAIMS INVESTIGATOR!!! $69,000 plus great benefits. Brooklyn location.


This position will be ideal for an experienced PA or RN who would like to expand beyond clinical practice.

JOB SUMMARY: This position is the primary investigator of lawsuits and occurrences at the institutions insured through Insurance Program. Additionally, this position also participates in committee meetings, risk management education programs and claims review activities. Assists in the defense of medical malpractice lawsuits, claims management, and identifies issues that may have an impact on the quality of care at insured institutions.
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ESSENTIAL DUTIES & RESPONSIBILITIES:

1. Investigate lawsuits, letters of claim and potential high exposure alerts, including reviewing and summarizing medical records, interviewing involved parties and generating comprehensive investigation reports.

2. Respond to defense counsel’s or the claim examiner’s investigation requests for hospital records and/or policies, obtains/provides relevant medical evidence, conduct relevant interviews. Document all actions for the insurance company's and hospital records.

3. Request security of appropriate documents and items relevant to the defense of cases according to specified procedures.

4. Review and integrate relevant information from the legal file and documents into the investigation process.

5. Provide risk management recommendations.

6. Prepare, dictate, and distribute investigation reports according to department guidelines.

7. Provide information on occurrences, issues, and findings to the Sr. RCC and hospital Risk Manager.

8. Review medical records for liability and authorize, on behalf of the client, their release as requested by attorneys or patients.

9. Attend in-house and client meetings if required.

10. Enter and update Oasis claim system data.

11. Review defense attorney correspondence as necessary.

12. Participate in RCC orientation program, as requested.

13. Perform other duties or special projects as required or as assigned.


PERFORMANCE MEASURES:

1. Dictate a minimum of 4 focused and well-written initial investigation reports monthly. Complete priority investigations by deadline date.

2. Respond to discovery requests by court-ordered return date. If unable to meet due date, must communicate with defense counsel.

3. Unasserted cases must be opened and clinical risk management codes entered in Oasis claim system within 4 weeks of receipt and review of the medical record.

QUALIFICATIONS:

Education/Certification:
Bachelor’s Degree preferred.
Registered Nurse ( RN ) or Physician Assistant ( PA )

Experience Required:
3 – 5 years of clinical hospital experience.

Skills/Abilities:
-Excellent knowledge of medicine required.
-Excellent interpersonal and interview skills.
-Strong verbal and communication skills.
-Strong writing skills.
-Ability to work independently and be flexible.
-Ability to multi-task.
-Ability to travel.

PHYSICAL DEMANDS:

The physical demands are minimal and typical of similar jobs in comparable organizations. Able to take public transportation and to transport medical records when necessary.

WORK ENVIRONMENT:

The work environment is representative and typical of similar jobs in comparable organizations.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

If you have questions, please call Katya Zaitseva at 212-683-0680.

Requirements
Requirements
See job description.