07/14/2006 03536

MEDICAL MALPRACTICE COVERAGE SPECIALIST SUPERVISOR

DEFINITION:

This is supervisory work in reviewing and examining medical malpractice insurance coverage filings to ensure compliance with medical professional liability insurance laws and regulations.

An employee in this job is responsible for supervising and participating in the review and analysis of medical malpractice coverage information in order to ensure the existence of adequate medical malpractice insurance coverage for health care providers and eligible professional corporations, professional associations and partnerships. Work includes determining the existence of basic insurance coverage; contacting insurance company representatives, attorneys, Department personnel, and other Commonwealth agencies to obtain additional information or other required documentation; calculating assessment fees and ensuring the appropriate funds are transmitted; determining eligibility for the Abatement Program; providing technical assistance to insurance company representatives or health care providers; and maintaining medical malpractice coverage records. Work is performed independently under the general direction of an administrative supervisor and is reviewed for conformance to policies and procedures through reports and conferences.

EXAMPLES OF WORK:

Supervises a technical staff involved in the review, analysis and approval or disapproval of medical malpractice insurance coverage filings.

Directs the conduct of on-site audits of medical malpractice insurance coverage filings, internal documents, and third party materials to ensure accuracy, completeness and compliance with Act 13.

Develops recommendations for and implements procedural changes.

Drafts correspondence to insurance company representatives to obtain missing or updated information.

Assists insurance company representatives with completing forms and submitting required information.

Provides technical assistance to insurance company representatives in order to insure compliance with medical professional liability insurance laws and regulations.

Maintains and updates medical malpractice insurance coverage records for health care providers and eligible professional corporations, professional associations and partnerships.

Informs parties of coverage requirements mandated by laws, regulations and policies.

Supervises the updating of assessment manuals in response to changes in legislation or policy.

Participates in meetings with insurance companies in order to distribute information, and to promote services provided.

Testifies at court and administrative hearings.

Performs the full range of supervisory duties.

Employees in this job may participate in the performance of their subordinates' work consistent with operational or organizational requirements.

Performs related work as required.

REQUIRED KNOWLEDGES, SKILLS, AND ABILITIES:

Knowledge of liability coverage principles and practices applicable to medical malpractice insurance.

Knowledge of provisions of medical malpractice insurance policies and related forms.

Knowledge of state laws and department regulations relating to medical malpractice insurance.

Ability to interpret and apply the principles and practices of supervision.

Ability to analyze medical malpractice insurance filings and related forms.

Ability to interpret and comprehend medical malpractice coverage principles and practices.

Ability to make arithmetical calculations.

Ability to establish and maintain effective working relationships.

Ability to communicate orally in a clear and concise manner.

Ability to communicate effectively in writing.

MINIMUM EXPERIENCE AND TRAINING:

One year of experience as a Medical Malpractice Coverage Specialist;

or

Four years of experience in reviewing and examining medical malpractice insurance filings, forms, or policies, and two years of college or business school;

or

An equivalent combination of experience and training, which included two years of experience in reviewing and examining medical malpractice insurance filings, forms or policies.