Claims-Litigation & Legal Process Specialist (Healthcare)

Job Summary

The Claims, Litigation & Legal Process Specialist is responsible for supporting the NCHS Legal Department's review, investigation and management of all claims and litigation, legal process and other legal proceedings involving the Health System and its affiliates and employees (whether as a party or a third-party), in collaboration with outside legal counsel, third-party administrator and insurance representatives (as applicable). Also provides support for Legal Department special projects involving claims and insurance and provides back-up support for the Legal Department's contract management process. Works under the supervision of the Legal Department attorneys and requires on-premises work at the Legal Department offices 2-5 days per week (as determined by supervising attorney).  

Job Specific Duties

• Prepares letter and email correspondence related to potential compensatory events (PCEs), claims and litigation matters directed to third party administrator, NCHS's outside counsel, counsel for other parties (in connection with subpoenas) and other recipients. 
  
• Leads or assists/supports Legal Department attorneys, the third-party administrator and outside counsel with the investigation of claims, PCEs or incidents (as applicable based on subject matter), including, but not limited to, research with staff, physicians, and in NCHS and other systems (e.g., electronic medical record, PolicyStat) to identify and obtain documents, information and fact witnesses related to claims and litigation matters. 
  
• Responsible for the collection, preservation, and transmittal of video footage, photographs, physical evidence (e.g., furniture), documents (electronic & paper), and information related to PCEs, claims and litigation matters. 
  
• Collaborates with third party administrator and/or outside counsel to coordinate witness interviews, unsworn statements, depositions, hearing or trial testimony for witnesses. 
  
• Responsible for the coordination and management of the Legal Department's support to physicians and staff required or requested to participate in a conference, deposition, hearing, or trial as a treating provider or fact witness in a third-party legal matter (Health System is not a party), such as matters involving the Florida Department of Children and Families, family law, criminal and personal injury cases. 
  
• Accepts service of court-related documents on behalf of Nicklaus Children's Health System (and its related entities) and employed physicians and staff. Collaborates with attorneys to address deficiencies or inaccuracies in service process or in served documents. 
  
• Collaborates with Legal Department attorneys in reviewing, drafting, and updating responses to subpoenas, Writs for Garnishments, discovery requests and other litigation filings. E-file responses in state or federal court, as applicable.
  
• Performs research related to legal cases and statutes (e.g., Florida Statutes, West Law, PACER, Florida Court E-filing portal).  
  
• Assists Legal Department attorneys with drafting, analysis and research for presentations and reports as to claims and litigation matters in support of internal stakeholder updates, and updates or renewal processes for insurance representatives.
  
• Actively monitors status of responses to subpoenas for medical records and other documents to Health System to ensure responses within legal established deadlines. 
  
• Participates in special projects related to claims, litigation and other Legal Department matters for and at direction of supervising attorney(s), ensuring deadlines/objectives are met. 
  
• Provide cross-functional support to Legal Department by serving as back-up for contract management process when Contract Administrator is out of the office, or additional support is needed due to contract volumes.

Minimum Job Requirements

• 5+ years of experience in management of liability claims and litigation support for civil litigation matters in a law firm (plaintiff or defense), corporate legal or risk department, or insurance company setting.
  
• Previous experience with medical negligence and general liability claims and litigation strongly preferred.

Knowledge, Skills, and Abilities

• Florida notary and experience in filing documents and case/docket searches in PACER (federal) and Florida Court E-filing portal preferred.
  
• Proficient in Microsoft 365 (Teams, Outlook, Excel, Word, PowerPoint).
  
• Experience in RL Solutions (incident reporting system), Legal Tracker (matter management application) and an electronic medical record (Cerner/Oracle or EPIC) is a plus.
  
• Excellent verbal and written communication skills; ability to interact effectively with third-party administrator(s), outside legal counsel, insurance representatives, and all tenure levels (e.g., management and staff) across departments and business units.
  
• Ability to use independent judgement and discretion and, to exercise authority within established limits, and to plan, organize and prioritize own daily routine in order to complete work under deadlines and to manage multiple priorities in a fast-paced environment and to be proactive and responsive with a strong sense of urgency.
  
• Strong analytical, organizational, and problem-solving skills with great attention to detail.
  
• Ability to work independently and to be a collaborative team member with strong interpersonal skills.
  
• Knowledge of legal and insurance terminology and principles, and the claims investigation, insurance reserving and litigation discovery process.