Claims Manager

Bon Secours Mercy Health

. Manage liability claims, including hospital and employed physician claims and claims covered by deductible policies .

Posted 11/9/2026full-timeRemote • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing liability claims, including hospital and physician claims, while effectively evaluating and resolving complex litigation matters. Proficient in coordinating with defense counsel and insurance staff to ensure optimal claim outcomes and compliance with organizational objectives.

Highest-signal resume keywords

Professional Liability Claims ManagementClaims ProcessingMediation TrainingRisk EvaluationAssociate In Claims (AIC) Certification

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims EvaluationLitigation ManagementFinancial Reserve SettingInsurance Coverage AnalysisNegotiation of ClaimsRisk InvestigationsExpert Review CoordinationClaims ValuationTrial Strategy DevelopmentBill Review Software

Soft Skills

AdaptabilityCommunicationNegotiationLeadership

Certifications & Qualifications

Associate In Claims (AIC) CertificationAssociate In Risk Management (ARM)

Industry Keywords

Liability ClaimsInsurance CoverageDefense Counsel ManagementLoss PreventionEarly Liability Review Program

About the role

Key responsibilities & impact

Manage liability claims, including hospital and employed physician claims and claims covered by deductible policies
Protect ministry assets by resolving claims within available insurance coverage parameters
Represent Bon Secours Mercy Health at pre-trial hearings, mediations, arbitrations, and trials
Manage and direct defense counsel according to organizational objectives and goals
Independently evaluate, reserve, and resolve claims and litigated matters within designated authority
Use risk investigations and expert reviews to evaluate liability and causation, set reserves, evaluate claim values, and negotiate or resolve claims
Determine when matters should proceed to litigation and trial
Assign defense counsel based on venue, claim type, and potential claim value
Work with outside defense counsel to manage and resolve claims and determine trial versus settlement strategy
Select appropriate medical experts to review cases and provide opinions on standard of care and causation
Review defense bills using bill review software and department guidelines
Conduct insurance coverage analysis across various lines of coverage
Coordinate with insurance staff on coverage issues
Work with Loss Prevention on claims qualifying for the Early Liability Review Program
Set accurate financial reserves promptly using experience and reserving formulas
Explain risk evaluations and resolution or litigation alternatives to market and group senior leaders
Explain claims and litigation processes to employed physicians named in lawsuits
Coordinate with Risk Management on investigations, discovery, claim valuation, litigation, and resolution
Maintain a diary system tracking claims from report through investigation, evaluation, discovery, and analysis
Obtain defense counsel reports and direct litigation efforts according to department guidelines

Requirements

What you’ll need

Bachelor's Degree in Finance, Accounting, Business, or similar field (required)
3 years handling Professional Liability Claims or equivalent experience (required)
Associate in Claims (AIC) Certification or Associate in Risk Management (ARM) preferred
5 years Claims Processing preferred
Ability to quickly learn and adapt to modern technologies as needed
Mediation training or demonstrable experience in negotiation of high value complex claims
Scheduled weekly hours: 40
Work shift: Days (United States of America)

Benefits

Comp & perks

Competitive pay
Incentives
Referral bonuses
403(b) with employer contributions (when eligible)
Medical, dental, vision, and prescription coverage
HSA/FSA options
Life insurance
Mental health resources and discounts
Paid time off
Parental and FMLA leave
Short- and long-term disability
Backup care for children and elders
Tuition assistance
Professional development support
Continuing education support