1+ months

Legal Claims Specialist

Abbott
Sylmar, CA 91342

Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 103,000 colleagues serve people in more than 160 countries.

Our location in Sylmar, CA, currently has an opportunity for a Legal Claims Specialist to join our Warranty and Claims team supporting our Medical Device Business Unit. The preferred candidate should be self-motivated and detail oriented and have excellent customer service skills. The Legal Claims Specialist investigates product liability claims and/or other claims presented directly by claimants. Candidate must possess strong communication skills to resolve and/or facilitate the resolution of claims with independent judgement and a high level of discretion.

WHAT YOU’LL DO

  • Performs work that requires knowledge of legal concepts and identifies legal issues related to assigned matters.
  • Resolves routine and moderately complex matters in areas of responsibility with minimal supervision.
  • Strategizes and consults with appropriate members of the Claims team (supervisor, manager and/or attorneys), in resolving claims.
  • Prepares a plan of investigation and communication upon notification of a claim.
  • Participates in tactical planning and assessment with the supervisor and/or attorney in negotiations with customers and patients.
  • Recommends and negotiates settlement of claims, as directed.
  • Manages moderately complex department projects using effective delivery strategies.
  • Reviews, evaluates, and develops reports to include data summaries across multiple databases, systems, and software.
  • Possesses solid knowledge of Abbott’s businesses supported and knowledge of the broader business impact.
  • Assesses the alleged complaint and performs investigations on claim allegations with all relevant stakeholders, including collection and evaluation of medical records, as appropriate.
  • Receives and responds appropriately to routine and non-routine requests using good judgment and effective communication skills.
  • Evaluates requests for compensation from patients. Evaluates documentation provided and conducts follow-up research with hospitals, insurance companies, and Medicare, as necessary.
  • Responsible for initial triage and assignment of routine claims to junior specialists.
  • Supports more senior claims specialists, supervisors or attorneys on more complex claims.
  • Supports and complies with U.S. Food and Drug Administration (FDA) regulations, other regulatory requirements, Company policies, operating procedures, processes, and task assignments.
  • Responsible for auditing department’s compliance with internal policies.
  • Responsible for accurate filing and reporting of settlements as required by Medicare Secondary Payer (MSP) reporting requirements included in Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007.
  • Responsible for generating reports and reconciling data discrepancies within existing databases.
  • Responsible for maintaining templates and prepares updates to templates.
  • Maintains positive and cooperative communications and collaboration with all levels of employees, customers, contractors, and claimants.
  • Performs other related duties and responsibilities, as assigned.

    EDUCATION AND EXPERIENCE YOU’LL BRING

    Required

Categories

Posted: 2020-09-02 Expires: 2020-10-21

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Legal Claims Specialist

Abbott
Sylmar, CA 91342

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