Insurance Specialist I

Job Description

ECU Health

About ECU Health

ECU Health is a mission-driven, 1,708-bed academic health care system serving more than 1.4 million people in 29 eastern North Carolina counties. The not-for-profit system is comprised of 13,000 team members, nine hospitals and a physician group that encompasses over 1,100 academic and community providers practicing in over 180 primary and specialty clinics located in more than 130 locations.

The flagship ECU Health Medical Center, a Level I Trauma Center, and ECU Health Maynard Children’s Hospital serve as the primary teaching hospitals for the Brody School of Medicine at East Carolina University. ECU Health and the Brody School of Medicine share a combined academic mission to improve the health and well-being of eastern North Carolina through patient care, education and research.

Position Summary

Oversight of ECU Health insurance products and functions, selected risk assessment and risk reduction services and management of selected claims and lawsuits.

Responsibilities

Maintain and evaluate insurance coverage.

Assemble data and assist with insurance renewals.

Evaluate coverage limits, deductibles and retentions.

Design and completes ad hoc reports related to coverage limits and audits.

Additions/deletions of coverage.


Manage selected claims/lawsuits including auto, property, GL, personal belongings/lost and found, other, etc.

Investigate and evaluate merits of claim.

Consult with counsel as needed.

Represent the insured entity through the entire litigation process.

Analyze bills, process payments.

Formulate a resolution strategy to ensure the best possible outcome.


Risk assessment and risk reduction activities.

Coordinate loss control visits by carriers.

Oversee driving program.

Monthly and ad hoc MVR checks.

Annual CDL MVR checks.

Review out of state/provisional MVRs.

Add/remove approved drivers.

Review HireRight compliance forms.

Committee representation.

Review contracts for hold harmless/indemnification and insurance language.

Provide data for benchmarking studies.

Assist with responding to re-credentialing requests.

Assist with educational activities and presentations.


Maintain and provide the appropriate responses to insurance needs.

Physician onboarding/off boarding and maintenance of insured physician roster.

Issue certificates of insurance.

Issue insurance verifications.

Issue claims history verifications.

Resident sign-out.

Minimum Requirements

Four-year college degree is required or higher.

ARM or CPHRM certification preferred.

Four years experience in healthcare, insurance, risk, legal, or business setting.

Two years experience can be substituted for 1 year education.

General Statement

It is the goal of ECU Health and its entities to employ the most qualified individual who best matches the requirements for the vacant position.

Offers of employment are subject to successful completion of all pre-employment screenings, which may include an occupational health screening, criminal record check, education, reference, and licensure verification.

We value diversity and are proud to be an equal opportunity employer. Decisions of employment are made based on business needs, job requirements and applicant’s qualifications without regard to race, color, religion, gender, national origin, disability status, protected veteran status, genetic information and testing, family and medical leave, sexual orientation, gender identity or expression or any other status protected by law. We prohibit retaliation against individuals who bring forth any complaint, orally or in writing, to the employer, or against any individuals who assist or participate in the investigation of any complaint.