Specialist – Insurance Risk JobPhoenix, AZ

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Why You'll Love This Job

Atlas Healthcare Partners exists to form strategic partnerships with health systems across the nation to develop, manage and operate Ambulatory Surgery Centers (ASCs) in their markets. As a key player in this rapidly growing healthcare segment, we are committed to providing exceptional care and outstanding customer service to every patient, every physician, every time. Our daily focus revolves around our core values of Integrity, Culture, Teamwork, Respect, and Results.

In addition to fostering a workplace that encourages professional growth and advancement, we provide industry-leading health and dental benefits, paired with a matching retirement package. We look forward to you being a vital part of our journey in shaping the future of healthcare.



Pay Class: Salaried

Pay Type: Full-Time

 

Pay Class: Salaried

Pay Type: Full-Time

 

POSITION SUMMARY

Under the direction of the Insurance Risk Manager, the Specialist – Insurance Risk will organize, monitor, and coordinate the general oversight and set up of general claims management. The ideal candidate will have general claims management knowledge, experience navigating the full lifecycle of claims, documenting in corresponding databases, and general certificate knowledge and policy structure.This is a newly established department, and the Specialist – Insurance Risk will directly support department best practices, automate efficiencies, and be a liaison for internal and external stakeholders who have questions on general processes and structure. The ideal candidate can bring a background in general insurance and claims and/or experience in property, automotive, workers compensation, or general liability.

 

ESSENTIAL FUNCTIONS

  • The Specialist – Insurance Risk will act as the Atlas liaison for all ASC locations, and outside applicable administrators to perform a variety of administrative tasks as it relates to insurance policy maintenance and claims administration.
  • Support and mentor Atlas staff on insurance resources, compliance standards, and insurance certificate requirements.
  • Coordinate, provide, and maintain insurance policies and certificate database required by either Atlas, JVs, or vendors according to contract requirements and in the future may procure general liability and professional liability.
  • Assist the Insurance Risk Manager with insurance policy renewals, insurance audits, and claims audits as applicable.
  • Act as the claim’s liaison on behalf of Atlas Healthcare Partners to assist employees and other interested parties, regarding claim procedures and related laws, completion of proper forms, scheduling of medical appointments or evaluations, and coordinating structured return to work.
  • Respond to and investigate Atlas claims, which may include but are not limited to worker’s compensation, property, automotive, or liability claims, and review insurance policies to determine the level of coverage.
  • Work with all applicable parties to ensure prompt and accurate claim submission and management.
  • Provide updates and reviews of claims data and assist the Insurance Risk Manager in the presentation of quarterly claims status for all Atlas policies.
  • Maintain and manage all claim files, including confidential employee files, claim investigation and evidence, and coordination with insurance broker or carrier.
  • Assist in the controlling of claims costs by utilizing available resources, promptly identifying potential needs for specialized services, and making proper notifications to the Insurance Risk Manager and other applicable parties.
  • May be required to testify or attend legal depositions or arbitrations regarding Worker’s Compensation claims practices and individual cases.
  • Other duties as assigned.

MINIMUM QUALIFICATIONS

  • High school diploma or equivalent.
  • Minimum 5 year’s experience working as an Insurance or Claims Administrator.
  • Experience with insurance policies, certificates, and insurance contract language.
  • Experience with claims administration, audits, and claims investigation.
  • Strong organizational, time management, and problem-solving skills.
  • Experience with office management tools, including Adobe Acrobat and MS Office
  • Strong written and oral communication skills, with close attention to detail. PREFERRED QUALIFICATIONS
  • Experience working with insurance brokers, insurance carriers, and claims adjusters.
  • Experience working with ambulatory surgical centers, joint ventures, and/or large hospital networks.
  • Insurance and/or risk management certifications such as (CIC, CRIS, CSIR, ARM).
  • Origami Risk Sof


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