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Insurance and Claims Management Specialist
2 months ago
Join Mount Sinai Medical Center, a leader in high-quality healthcare.
Since its inception, Mount Sinai Medical Center has been dedicated to providing exceptional healthcare services to a diverse community. Our commitment to clinical excellence is reflected in our recruitment and training of top-tier healthcare professionals from across the nation. We operate state-of-the-art facilities throughout the region, offering a wide range of medical services including emergency care, cancer treatment, orthopedics, and cardiovascular services. As South Florida's largest independent not-for-profit hospital, we are devoted to nurturing the next generation of healthcare innovators.
Our Caring Culture: The Sinai Way
Our dedicated team of over 4,000 employees creates a supportive environment that prioritizes care and compassion. Each team member plays a crucial role in our mission to deliver outstanding healthcare through innovation, education, and research. At Mount Sinai, we take pride in our accomplishments and strive to be a leading provider of quality healthcare in South Florida. We invite all healthcare professionals to join our vibrant community and contribute to our pursuit of clinical excellence.
Key Responsibilities:
- Facilitates risk management inquiries to the appropriate departments for resolution.
- Demonstrates a thorough understanding of risk management processes in daily operations.
- Handles confidential and sensitive information with discretion.
- Processes reimbursement requests for lost items and maintains documentation in the incident reporting system.
- Serves as the system administrator for the claims database.
- Informs insurance providers of potential and actual claims as directed by management.
- Keeps loss run reports current by entering all relevant financial transactions promptly.
- Generates loss run reports for insurance representatives and actuarial services as needed.
- Completes payment requests related to claims in accordance with established policies.
- Maintains organized claim files in both paper and digital formats for easy access.
- Acts as a liaison with various departments to ensure timely production of records for claims investigations.
- Coordinates schedules for legal proceedings and ensures effective communication with involved parties.
- Reviews medical records to compile necessary information related to claims.
- Communicates with patients regarding their concerns and assists in resolving issues.
- Maintains secure and confidential claim files.
- Assists in gathering discovery information and responding to legal inquiries.
- Maintains accurate records of all closed claims for efficient retrieval.
- Supports the Manager of Claims and Insurance with insurance applications and documentation.
- Acts as a notary for legal documents as required.
- Provides claims history and insurance certificates for healthcare professionals as needed.
- Maintains updated records of insured personnel and properties.
- Preferred: Licensed Risk Manager in the State of Florida.
- Associate or Bachelor's degree.
- Minimum of two years of experience in Healthcare Risk Management preferred.
We prioritize the well-being of our employees and offer a comprehensive benefits package tailored to meet their needs, including:
- Health insurance
- Life insurance
- Long-term disability coverage
- Healthcare spending accounts
- Retirement savings plan
- Paid time off
- Pet insurance
- Tuition reimbursement
- Employee assistance program
- Wellness initiatives
- On-site housing for select positions and more
