Are you passionate about making a difference in people's lives? Do you enjoy working in a service-oriented industry? If so, this opportunity may be the right fit for you!

This position is responsible for managing the operations of the intake of claims for the Legal Department to meet operational, financial and service requirements. This includes leading the intake and processing of insurance claims for personal, property and casualty loss. In addition will develop and implement best practices for claims resolutions and investigations following company policies and procedures.

This role...

• Insurance Claims Reporting Process:

• Acts as the primary point of contact for all insurance claims.

• Reports all claims and litigation to appropriate insurers.

• Coordinates and collaborates with insurance adjusters and claim advocates.

• Pre-litigation Claims:

• Communicates with claimants and their attorneys as needed.

• Engages with claimant attorneys to gather additional information.

• Submits claims to third parties when appropriate.

• Conducts initial investigation and evaluation of claims.

• Obtains internal documentation and records related to claims (ie: obtain TP agreements, COIs, clinical/employee records, etc.)

• Identifies and ensures legal holds are made timely.

• Develops process to organize and keep track of pre-litigation claims.

• Coordinates with internal counsel, insurance carriers, adjusters, attorneys, and other stakeholders to resolve claims expeditiously and favorably.

• Collaborates with internal counsel on early resolution of claims.

• Collaborates with internal counsel to determine need for early engagement of outside counsel.

• Manage Claims Handling Process:

• Contributes to the development of best practices for claims handling processes (incident through litigation).

• Develops and implements claims handling procedures to improve efficiency and effectiveness.

• Leads claim reviews and ensures claims reviews are held timely.

• Ensures Adjusters are responsive by providing periodic analysis on effectiveness.

• Develops a Claims Reporting/Handling Manual/Tool Kit.

• Manage Significant Incident Process

• Oversees YORS Tier 1 Incidents.

• Participates in emergency calls to identify potential claims and make recommendations related to incidents.

• Evaluates significant incidents and reports to insurers as necessary.

• Consults with internal counsel where outside defense counsel should be retained or in matters that are of a certain threshold of severity.

• Provides better and improved processes on the front end of incidents.

• Recognizes when we need legal holds.

• Reports to carrier when appropriate.

• Litigation Management:

• Collaborates with internal counsel, outside counsel, and insurance carriers on pending litigation as necessary

• Ensures timely payment of claims/litigation.

• Assists in evaluation of MODV defense counsel panels.

• Provide assistance in mediations and other matters.

• May lead projects and perform other duties as assigned.

We are excited to speak with individuals with the following...

• Bachelor's Degree required.

• Ten (10) plus years of experience managing large claims and claims processes.

• Or equivalent combination of education and/or experience.

Salary: $92,500.00 - 124,900.00

Modivcare’s positions are posted and open for applications for a minimum of 5 days. Positions may be posted for a maximum of 45 days dependent on the type of role, the number of roles, and the number of applications received. We encourage our prospective candidates to submit their application(s) expediently so as not to miss out on our opportunities. We frequently post new opportunities and encourage prospective candidates to check back often for new postings.

We value our team members and realize the importance of benefits for you and your family.

Modivcare offers a comprehensive benefits package to include the following:

• Medical, Dental, and Vision insurance

• Employer Paid Basic Life Insurance and AD&D

• Voluntary Life Insurance (Employee/Spouse/Child)

• Health Care and Dependent Care Flexible Spending Accounts

• Pre-Tax and Post --Tax Commuter and Parking Benefits

• 401(k) Retirement Savings Plan with Company Match

• Paid Time Off

• Paid Parental Leave

• Short-Term and Long-Term Disability

• Tuition Reimbursement

• Employee Discounts (retail, hotel, food, restaurants, car rental and much more!)

Modivcare is an Equal Opportunity Employer.

• EEO is The Law - click here for more information (https://www.eeoc.gov/laws-guidance)

• Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled

• We consider all applicants for employment without regard to race, color, religion, sex, sexual orientation, national origin, age, handicap or disability, or status as a Vietnam-era or special disabled veteran in accordance with federal law. If you need assistance, please reach out to us at hr.recruiting@modivcare.com

Due to system issues, if you are unable to search for your application, please reach out to the Talent Acquisition team via email at hr.recruiting@modivcare.com and a member of the Talent Acquisition team will reach out to you within the next 48 business hours. We appreciate your interest in joining Modivcare!

Our goal isn’t a number. It’s a difference.

Modivcare is leading the transformation to better connect people with care, wherever they are. We serve the most underserved by facilitating non-emergency medical transportation (https://www.modivcare.com/offerings/nemt) and personal and home care (https://www.modivcare.com/offerings/personal-care) to enable greater access to care, reduce costs and improve outcomes.

Please note, Modivcare will never ask any potential applicant for employment for any Personal Identifiable Information via social media. Additionally, Modivcare will never ask any applicant for money. Please be cautious of any individual posing as a recruiter for Modivcare requesting personal identifiable information. If you suspect someone is attempting to collect your personal information or solicits money from you via any social media platform, we encourage you to report such scammers to that platform.

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