Risk and Insurance Consultant

Department Name:

Risk Financing & Ins Programs

Work Shift:

Day

Job Category:

Risk, Quality and Safety

Estimated Pay Range:

$39.00 - $65.00 / hour, based on location, education, & experience.

In accordance with State Pay Transparency Rules.

Great careers are built at Banner Health. There’s more to health care than doctors and nurses. We support all staff members as they find the path that’s right for them. Apply today, this could be the perfect opportunity for you.

Becker’s Healthcare recently honored Banner as one of 150 top places to work in health care for 2024, we are proud to offer our team members many career and lifestyle choices throughout our network of facilities. At Banner Health, we’re excited about what the future holds for health care. That’s why we’re changing the industry to make the experience the best it can be. If you’re ready to change lives, we want to hear from you.

This role is remote with a flexible schedule typically 8 hours per day starting at 8am. In this Risk & Insurance Consultant role you will be responsible for handling complex claims for various lines of coverage. This will include investigations, carrier reporting, and collaborating with the carrier to bring the claims to resolution.  This position will also provide claims oversight functions, for internal team members and our third party administrator, such as payment audits, claim reviews, and claim audits .Having experience working with a Risk Management Information System (RIMS) such as Riskonnect or Origami would be a big plus

This is a fully remote position and available if you live in the following states only: AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, MI, MN, MO, MS, NC, ND, NE, NM, NV, NY, OH, OK, OR, PA, SC, TN, TX, UT, VA, WV, WA, WI & WY.

Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care.

POSITION SUMMARY

This position provides direction and consultation to internal customers in relation to risk evaluation, risk transfer and risk financing with the objective of protecting the assets of the corporation. Acts as an adviser in the areas of decision making, mitigating risks where appropriate relating to insurance policies, and claim investigation. This position is responsible for handling complex claims and overseeing the submission of first level claim information for various lines of coverage to include the management of investigations and collaboration with the insurance carrier. This position will provide claims oversight functions such as, but not limited to, payment audits, claim reviews, and claim audits. Verifying and monitoring all payments for claims and non-claims related expenses to ensure they are properly coded, fall within the scope contract and fit within the budgeted parameters. Assists with the design and development of the insurance programs in order to minimize the adverse impact on the financial performance of the organization through the use of commercial insurance, and deductible programs. This includes but is not limited to property, auto, directors’ and officers’ liability, general and professional liability, workers compensation, fiduciary, builders’ risk, and environmental coverage. Assists the activities of insurance brokers, captive risk management consultants and other consultants as needed for risk management.

CORE FUNCTIONS
1. Interprets internal and external business challenges and recommends best practices to improve services, processes or products.

2. Solves complex problems. Takes a broad perspective including coordination with others outside own work unit, to identify innovative solutions.

3. Anticipates customer needs; assesses requirements and identifies new solutions. Interacts primarily with department and cross-department peers, supervisor, customers, peers’ managers, patients and physicians.

4. Makes decisions guided by policies in non- standard situation. Impacts the achievement of operational, project or service objectives. Monitors and controls costs of own work and may manage budgets for moderate sized projects or programs.

MINIMUM QUALIFICATIONS

Bachelor’s Degree required either in management or business

Significant experience, typically gained through seven plus years relevant experience

Must have significant experience with claims, risk finance and commercial insurance. Must have a broad knowledge of problem solving and strong communication skills with claims handling. Must be self-directed and have excellent interpersonal, time management, organizational and problem solving skills. Extensive experience with patient and customer communication, investigation and data collection/analysis. Be able to lead and manage change.

PREFERRED QUALIFICATIONS

Masters' Degree in business or Insurance preferred. ARM (Associate of Risk Management) or CPCU (Chartered Property Casualty Underwriter) preferred. Broker and/or insurance company experience preferred.

Additional related education and/or experience preferred.

EEO Statement:

EEO/Female/Minority/Disability/Veterans

Our organization supports a drug-free work environment.

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